Thyroid-like follicular carcinoma of the kidney in a patient with nephrolithiasis and polycystic kidney disease: a case report

Abstract

Thyroid-like follicular carcinoma of the kidney (TLFC), a rare neoplasm with low malignant potential, is histologically similar to primary thyroid follicular carcinoma, but characteristically lacks thyroid immunohistochemical markers. We report a case of 34-year old patient with nephrolithiasis. Ultrasound revealed hepatorenal cysts consistent with adult type polycystic kidney disease (ATPKD) and a cytologically confirmed left kidney tumor. Nephrectomy specimen contained sharply demarcated lesion of unusual morphology. Tubular and cystic structures lined by mostly cuboidal cells and filled with amorphous eosinophillic material, reminiscent of follicular carcinoma of the thyroid gland, were diagnostic for TLFC. Thyroid markers were negative. To our knowledge this is the first report of TFLC associated to ATPKD. Brief review of previously published TFLCs, possible relationship between entities and differential diagnosis are discussed.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8067946569612694

New and emerging renal entities: a perspective post‐WHO 2016 classification

“…The tumour size is variable, ranging from 11 to 118 mm in the greatest dimension. Thyroid‐like follicular carcinoma of the kidney usually follows a non‐aggressive and indolent clinical course, although several patients with metastases in the regional lymph nodes, lung, retroperitoneum, skull and meninges have been reported …”

“…Thyroid-like follicular carcinoma of the kidney usually follows a non-aggressive and indolent clinical course, although several patients with metastases in the regional lymph nodes, lung, retroperitoneum, skull and meninges have been reported. [31][32][33][34][35][36] Grossly, thyroid-like follicular carcinoma of the kidney appears well-circumscribed and encapsulated, and the cut surface is tan-brown to dark brown. On microscopy, there is a distinct follicular pattern and thyroid-like morphology, with variable-size follicles filled with colloid-like content, resembling follicular carcinoma of the thyroid (Figure 2A-F).…”

Thyroid-like follicular carcinoma of the kidney presenting on a ten year-old prepubertal girl

“…No cases presented with vascular or collecting system invasion. Capsular invasion was seen in two cases (11). …”

“…PET (+).Biopsy + P nephrectomy/ 21 months NED.Wang 2017 (2)25 FSevere hypertension (normal post-operative)Normal thyroid (I/F), normal ovaries (I)R MP 30(CT) inhomogenous enhancement, calcifications. Ovaries normal (imaging).P/ 2 years NED.Ghaouti 2014 (10)68 FIncidentalNormal thyroid (I/F), normal ovaries (I)R MP 11(MRI) Cystic, no enhancementP/ no FU reportedVolavsek 2013 (11)34 ?IncidentalNephrolithiasis,polycystic disease, adult type.L LP 50 mmHyperechogenic cystT/ 6 months NED.Sterlacci 2008 (6)28 FIncidental L MP 44(CT) Heterogeneous, no capsule infiltration, displacement of blood vessels. Left lung nodule.Thyroidectomy (presumed metastatic thyroid cancer, despite normal imaging).…”

Thyroid-like follicular carcinoma of the kidney: a case report and review of the literature

“…With only 11 mm in diameter, our patient’s tumor is the smallest case described, as the diagnosis was performed in a partial nephrectomy specimen. In one case, TLFCK was diagnosed in a patient with polycystic kidney disease [8]. Although the majority of cases were low grade with an indolent course, one patient developed metastatic extension to the renal hilar lymph nodes and another presented with marked symptoms and widespread metastases to the lungs and retroperitoneal lymph nodes.…”