Renal collision tumour of papillary cell carcinoma and chromophobe cell carcinoma with sarcomatoid transformation: A case report and review of the literature

Zhang, Zhiqiang; Min, Jie; Yu, Dexin; Shi, Hao; Xie, Dong

doi:10.5489/cuaj.1811

Cited by 13 publications

(21 citation statements)

References 16 publications

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“…The earliest case was reported by Graves and Templeton (12) in 1921, and the most recent one was reported by Atilgan et al (2) in 2013. According to Pubmed search results, ~40 cases of synchronous ipsilateral RCC and renal pelvic UC have been reported in the literature to date (2,3,14,15). The average age of the reviewed patients was 65±11 years; the male/female ratio was 1.6; and the left-to-right-side ratio was 1.9.…”

Section: Discussionmentioning

confidence: 97%

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Renal cell carcinoma with synchronous ipsilateral urothelial carcinoma of the renal pelvis

Lü

Zhuang

2017

Oncology Letters

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Abstract. The simultaneous occurrence of renal cell carcinoma (RCC) and urothelial carcinoma (UC) in the same kidney is extraordinarily rare, and is also known as multiple primary malignant tumors. The present study reports the case of a 76-year-old female with synchronous ipsilateral RCC and UC of the renal pelvis, who underwent operation, chemotherapy and reoperation when recurrence of RCC or UC was identified. Cluster of differentiation 44 (CD44) is one of the promising markers for identifying cancer stem cells in various solid tumors, along with aldehyde dehydrogenase 1 A1 (ALDH1A1). Detection of CD44 and ALDH1A1 prior to and subsequent to chemotherapy could provide useful prognostic information. New treatments against the cancer stem cells fraction should be used in combination with chemotherapy to improve the outcome for patients with overexpression of CSC markers. IntroductionCombined renal cell carcinoma (RCC) and urothelial carcinoma (UC) of the renal pelvis is a rare type of multiple primary malignant tumor, which is characterized by the coexistence of two histologically distinct malignant tumors in the same organ with a shorter median time to relapse and mortality compared with a solitary tumor (1). There are only a few such cases in the world (2,3). Research into prognostic markers of multiple primary malignant tumors is important to establish adequate therapeutic strategies. Cancer stem-like cells (CSCs) are a small population of cancer cells that have the properties of tumor-initiating ability, self-renewal and differentiation (4). CSCs are more resistant to chemotherapy and radiotherapy than non-CSC populations via various mechanisms (5). Several studies have indicated that detection of CSC markers such as cluster of differentiation 44 (CD44) and aldehyde dehydrogenase 1 A1 (ALDH1A1) in urologic neoplasms can provide useful prognostic information (6-8). Furthermore, CD44 and ALDH1A1 have demonstrated high levels of activity in several types of solid cancer (9).The present study reports a case of synchronous RCC and UC of the left kidney with poor prognosis. Abnormal expression of CD44 and ALDH1A1 CSC markers investigated prior to and subsequent to chemotherapy may indicate poor prognosis. Materials and methods Patient.A 76-year-old female with a 5-month history of left flank pain presented to the Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School (Nanjing, China) without a history of fever, fatigue, weight loss or gross hematuria in March 2014. Her medical history included an 8-year history of hypertension, and there was no family history of urologic malignancies. Physical examination revealed that her vital signs were stable, and no palpable abdominal mass could be detected. Results from routine examinations, including electrocardiogram, chest radiography, pulmonary function test and laboratory tests of blood and urine, were all within the normal limits, with the exception of 8.4 red blood cells (RBC)/µl in urine (normal range, 0-5 RBC...

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Section: Discussionmentioning

confidence: 97%

“…The average age of the reviewed patients was 65±11 years; the male/female ratio was 1.6; and the left-to-right-side ratio was 1.9. In total, 73% of the cases presented with hematuria, 37% with flank pain and 10% without obvious symptoms, and no identifiable past medical history could be observed (2,3,(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

Renal cell carcinoma with synchronous ipsilateral urothelial carcinoma of the renal pelvis

Lü

Zhuang

2017

Oncology Letters

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“…The occurrence of a papillary component within renal oncocytic tumors is often underestimated and, in case, simply regarded as a collision tumor. This type of renal collision tumors has been widely described in case reports as histological findings [ 5 , 11 ]. A recent report investigated the phenotypic and cytogenetic features of these lesions, concluding that the two histological counterparts are different and should be considered colliding neoplasms [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Renal Tumors with Oncocytic and Papillary Features: A Phenotypic and Genotypic Study

et al. 2021

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The occurrence of kidney oncocytic lesions with an admixed papillary component is not unusual in routine pathology practice. These neoplasms with dual morphology are classically recognized as collision tumors with variable malignant potential. Using immunohistochemistry, we investigated fluorescent in situ hybridization and next generation sequencing of the genetic and phenotypic profiles in the two components of 11 kidney tumors with colliding oncocytic and papillary features. The oncocytic component was CD117 positive, CK7 negative, and AMACR negative; the papillary component was CK7 positive, AMACR positive, and CD117 negative in all cases. Fluorescence in situ hybridization (FISH) results were inconsistent. Next generation sequencing (NGS) analysis demonstrated that the mutations identified in the two tumor components were identical and displayed an allelic frequency of approximately 50%, strongly suspicious for genetic polymorphisms. The two oncocytic and papillary tumor counterparts shared the same genetic profile and did not harbor pathogenic mutations. Clinical confirmation of the biological benign features of these tumors is required. The term collision tumor is not suitable for these neoplasms, and we propose the term oncopapillary tumor for this histological entity.

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“…A collision tumor is defined as the coexistence of 2 adjacent but histologically distinct and independent malignant tumors in the same thyroid, without histological admixture [10]. Collision tumors can occur in various organs such as the ovaries, colon, lung, stomach, skin, and kidneys, but they are extremely rare in the thyroid [11]. It has also been suggested that each malignant component should be treated as an independent primary tumor [12].…”

Section: Discussionmentioning

confidence: 99%

Port-Site Implantation Diagnosed by Iodine-131 Post-Ablation Single-Photon Emission Tomography-Computed Tomography After Robotic Thyroidectomy: A Case Report

Kim

Shim

2019

Am J Case Rep

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Patient: Female, 37Final Diagnosis: Port-site implantation after robotic thyroidectomySymptoms: NoneMedication: —Clinical Procedure: Iodine-131 post-ablation whole body scan and single photon emission tomography-computed tomographySpecialty: Nuclear MedicineObjective:Unusual or unexpected effect of treatmentBackground:Robotic thyroidectomy using remote access approaches is currently regarded as the optimal surgical protocol for highly selected patients. This approach has excellent cosmetic outcomes compared with conventional open transcervical thyroidectomy. Although the remote access approach offers significant benefits, it can cause complications associated with the large working space required for surgery. Such complications can lead to unusual imaging findings.Case Report:We report a case of a 37-year-old woman with thyroid cancer who underwent robotic thyroidectomy and demonstrated unusual port-site implantation findings on post-treatment iodine-131 whole-body scintigraphy and single-photon emission computed tomography-computed tomography. Evaluation of stimulated thyroglobulin and additional imaging studies did not reveal any remarkable findings. Through a multidisciplinary discussion, we discovered that the bag had developed a tear during specimen retrieval. Our patient was administered a therapeutic dose of radioiodine, which accumulated within the target area and successfully ablated the implanted tissue. Follow-up imaging and biochemical studies were normal after a follow-up period of 7 years.Conclusions:Port-site seeding is a rare and unexpected surgical complication; however, it can be treated with radioiodine therapy involving a therapeutic dose. Meticulous surgical manipulation is essential to prevent port-site implantation related to spillage and tearing of thyroid or cancer tissue. Awareness and identification of these rare complications, which manifest as unusual imaging findings, are critical for improving the accuracy of interpretation.

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Renal collision tumour of papillary cell carcinoma and chromophobe cell carcinoma with sarcomatoid transformation: A case report and review of the literature

Cited by 13 publications

References 16 publications

Renal cell carcinoma with synchronous ipsilateral urothelial carcinoma of the renal pelvis

Renal cell carcinoma with synchronous ipsilateral urothelial carcinoma of the renal pelvis

Renal Tumors with Oncocytic and Papillary Features: A Phenotypic and Genotypic Study

Port-Site Implantation Diagnosed by Iodine-131 Post-Ablation Single-Photon Emission Tomography-Computed Tomography After Robotic Thyroidectomy: A Case Report

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