Synchronus renal cell carcinoma and Bellini duct carcinoma: a case report on a rare coincidence

Auguet, Teresa; Molina, Javier; Lorenzo, Alfons; Vila, J. H. Garcia; Sirvent, Juan J.; Richart, C

doi:10.1007/s003450000157

Cited by 24 publications

(24 citation statements)

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“…Auguet et al reported a case of BDC and highlighted the possibility of a strong family history of associated malignancy in BDC patients; however, this theory is controversial, as there is little supporting published data (10,12). In the two cases reported in the present study, there was no family history of BDC.…”

Section: Discussioncontrasting

confidence: 49%

“…BDC is most common in older men (>40 years old), with a mean age of diagnosis of 58.2 years; however, the majority of BDC patients are younger than classical RCC patients, which occurs predominantly in the seventh and eighth decades of life (7,10,11). Auguet et al reported a case of BDC and highlighted the possibility of a strong family history of associated malignancy in BDC patients; however, this theory is controversial, as there is little supporting published data (10,12).…”

Section: Discussionmentioning

confidence: 99%

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Bellini's duct carcinoma: A report of two cases and a review of the literature

Jin

Lü

et al. 2016

Oncology Letters

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Abstract. Bellini's duct carcinoma (BDC) is a rare and aggressive variant of renal cell carcinoma that possesses an extremely poor prognosis. The greater the grade or stage of disease, the poorer the prognosis tends to be. This study presents two cases of BDC; one case of low grade BDC and one case of high grade BDC in a 47-year-old male and 74-year-old female, respectively. The 47-year-old male patient presented with painless gross hematuria, which had lasted for 3 weeks and subsequently underwent purely laparoscopic nephroureterectomy. After 4-years of follow-up, the patient remained disease-free. By contrast, a right renal tumor was identified in the 74-year-old female patient during a routine examination. Radical right nephrectomy and lymph node dissection were performed, however, 10 months after surgery the patient succumbed due to wide-spread metastasis. The two cases reported in the present study not only represent excellent examples of the disease spectrum, but also act as a reminder of the possibility of detecting BDC in an early stage of disease. Therefore, the epidemiology of BDC has been discussed, and the aggressive growth pattern of BDC has been presented in terms of signs, symptoms and imaging examinations, including ultrasonography, computed tomography (CT), angiography and single photon emission CT, in the early stage of disease. IntroductionBellini's duct carcinoma (BDC), which arises from the distal segment of the collecting duct, is a rare and aggressive malignant tumor with a poor prognosis. BDC comprises <1% of all renal tumors (1), but it is extremely aggressive and is accompanied by metastatic diseases in the majority of reported cases. The prognosis of BDC is poor, with ~70% patients succumbing due to disease progression within 2 years of diagnosis (2). The only favorable prognosis factor is low-grade and low-stage disease (3-5). If BDC could be detected in the early stage of disease, the poor prognosis of BDC may be changed. However, due to the rarity of BDC, the similarities of the symptoms, signs and imaging examination findings with other variants of renal cell carcinoma (RCC), and the poor prognosis of BDC, it is challenging and crucial to differentiate other RCC variants from BDC. The RCC database of Peking University Shenzhen Hospital (Shenzen, China) was reviewed, and out of a total of 311 RCC cases, two cases of BDC with different grades of disease and prognoses were identified. Case reportCase one. In December 2010, a 47-year-old man presented to the Department of Urology, Peking University Shenzhen Hospital, with a complaint of painless gross hematuria during urination that had lasted 3 weeks. Physical examination revealed percussion pain over the left kidney region. The laboratory examinations revealed no extrarenal manifestations. The blood routine examination revealed no anemia and polycythemia; electrolyte examination revealed no hypercalcemia; erythrocyte sedimentation rate (ESR) examination revealed no fast ESR; and alkaline phosphatase examination revealed no elevated a...

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Bellini's duct carcinoma: A report of two cases and a review of the literature

Jin

Lü

et al. 2016

Oncology Letters

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“…Sparse case reports exist of composite collecting duct carcinomas with elements of either clear cell [8,15], chromophobe [22], or papillary RCC [30]. Furthermore, a case of renal oncocytoma with evolving papillary RCC has been reported [3].…”

Section: Discussionmentioning

confidence: 98%

A renal cell carcinoma with components of both chromophobe and papillary carcinoma

et al. 2006

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We report a case of a morphologically unusual renal cell carcinoma with features of both chromophobe and papillary carcinoma. Immunohistochemical analysis of high molecular weight cytokeratins (HMWCK), cytokeratin 7 (CK7), cytokeratin 19 (CK19), c-Kit, and alpha-methylacyl-CoA racemase (AMACR) demonstrated differential profiles for the two components of the tumor, consistent with the respective patterns commonly observed for pure chromophobe and papillary renal cell carcinomas. Specifically, the chromophobe tumor cells expressed CK7 and c-Kit weakly, while HMWCK, CK19, and AMACR were not detectable. In contrast, the papillary tumor cells expressed uniformly HMWCK, CK7, and c-Kit and focally CK19 and AMACR. Fluorescence in situ hybridization analysis of nuclei isolated from paraffin-embedded tumor tissue detected monosomy 1, disomy 7, and monosomy 17, a common and characteristic finding in chromophobe carcinomas, in a majority of, but not all tumor cells, whereas a population characterized by disomy 1, trisomy 7, and trisomy 17, a frequent finding in papillary carcinoma, was not identifiable. Electron microscopic analysis revealed numerous characteristic small cytoplasmic vesicles in the chromophobe areas, which were absent in the papillary component. This case illustrates the rare coexistence of two distinct and admixed histologic types of renal cell carcinoma.

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“…The majority of CDC tumors have been found to demonstrate focal cortical extension, while perirenal invasion was also common in large tumors (15). Since these tumors do not exhibit specific imaging features, a microscopic examination and immunohistochemical staining are required for the diagnosis of CDC (1). Microscopically, the common features include a tubulopapillary architecture, atypical hyperplastic changes, clear cytoplasm, evident stromal reaction with fiber hyperplasia and detached single cells with a …”

Section: Discussionmentioning

confidence: 99%

“…Collecting duct carcinoma (CDC) is a rare subtype of renal epithelial neoplasm, accounting for <2% of all the renal cell carcinoma (RCC) cases (1). This aggressive malignancy is considered to be derived from the collecting duct of the kidney and has a poor prognosis in the majority of patients (2-5) with a median survival time of only 22 months following nephrectomy (6).…”

Section: Introductionmentioning

confidence: 99%

Collecting duct carcinoma of the kidney: A case report

Zhou

Wang

et al. 2015

Oncology Letters

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Abstract. Collecting duct carcinoma (CDC) is a rare type of renal tumor, arising from the distal collecting ducts. The prognosis of this disease is extremely poor due to its rapid progression with widespread metastases. The present study reported a case of CDC involving the right renal region of a 62-year-old female patient, presented with right-flank pain that had persisted for one month. A computed tomography scan demonstrated multiple hypoattenuating quasicircular lesions, 0.5-4.3 cm in size, in the upper pole of the right kidney. Following the diagnosis of a right renal tumor, laparoscopic radical resection of the right kidney was performed. Pathological examination demonstrated that the tumor cells were arranged in a glandular or papillary pattern, and marked cytological atypia was observed. Immunohistochemical staining revealed that the tumor cells were positive for epithelial membrane antigen and cytokeratin (CK)7, while they reacted focally with vimentin. However, the tumor cells were negative for CK20, CD10, uroplakin Ⅲ and p63. Based on these findings, the patient was diagnosed with CDC. In conclusion, immunohistochemical analysis is critical in establishing an accurate diagnosis of CDC and distinguishing this tumor from other subtypes of RCC. IntroductionCollecting duct carcinoma (CDC) is a rare subtype of renal epithelial neoplasm, accounting for <2% of all the renal cell carcinoma (RCC) cases (1). This aggressive malignancy is considered to be derived from the collecting duct of the kidney and has a poor prognosis in the majority of patients (2-5) with a median survival time of only 22 months following nephrectomy (6). Despite the histological and immunohistochemical features of this disease, distinguishing CDC from pelvic urothelial carcinoma and high-grade papillary RCC is difficult, mainly due to the varying features of CDC (7). The tumor is usually identified in or proximal to the renal pelvis and appears gray or white without extensive necrosis or hemorrhage (8).Various treatments have been reported in the literature, including immunotherapy, radiation therapy, chemotherapy (5,9) and radical excision (3). In order to improve the understanding on the biological behavior of CDC, the present study reported the case of a 62-year-old female patient with typical pathological features of CDC. In addition, the clinical, pathological and immunohistochemical aspects of the disease were reviewed. Written informed consent was obtained from the patient. Case reportIn August 2013, a 62-year-old female was admitted to the First Hospital of Jilin University (Changchun, China) for evaluation of right-flank pain that had persisted for one month. The patient did not experience gross hematuria or dysuria. A physical examination was unremarkable, with the exception of mild percussion pain in the right kidney area. Blood examinations revealed an elevated erythrocyte sedimentation rate [41 ml/h; normal range, 4-30 ml/h (10)]. An abdominal ultrasonography scan demonstrated a solid, hypoechoic and relatively well-demar...

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Synchronus renal cell carcinoma and Bellini duct carcinoma: a case report on a rare coincidence

Cited by 24 publications

References 0 publications

Bellini's duct carcinoma: A report of two cases and a review of the literature

Bellini's duct carcinoma: A report of two cases and a review of the literature

A renal cell carcinoma with components of both chromophobe and papillary carcinoma

Collecting duct carcinoma of the kidney: A case report

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