Renal collecting duct carcinoma complicated with clear cell carcinoma of kidney: one case report / 中华泌尿外科杂志

Renal collecting duct carcinoma(CDC) is rare in clinic, complicated with clear cell renal cell carcinoma(ccRCC) of one kidney is extremely rare. We reported a case CDC complicated with ccRCC of one kidney. The patient was admitted as left low back pain and gross hematuria, preoperative CT examination showed that one tumor was found in the upper middle pole and another tumor at lower pole of the left kidney, and multiple enlarged lymph nodes in the medial edge of the kidney. CT diagnosis was renal collecting duct carcinoma complicated with clear cell carcinoma of the left kidney, retroperitoneal lymphatic metastasis and underwent radical nephrectomy. Postoperative pathological diagnosis was CDC(upper middle pole) complicated with ccRCC(lower pole)of the left kidney. The patients were treated with sunitinib for 6 months and survived 13 months, and died of extensive metastasis.

Hereditary leiomyomatosis and renal cell carcinoma syndrome-associated renal cell carcinoma: Morphological appraisal with a comprehensive review of differential diagnoses

Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is an autosomal dominant syndrome wherein affected individuals are at risk for the development of cutaneous leiomyomas, early-onset multiple uterine leiomyomas, and an aggressive subtype of renal cell cancer. HLRCC is caused by germline mutations in the fumarate hydratase (FH) gene, which inactivates the enzyme and alters the function of the tricarboxylic acid/Krebs cycle. This article reviews the hitherto described morphologic features of HLRCC-associated renal cell carcinoma (RCC) and outlines the differential diagnosis and ancillary use of immunohistochemistry and molecular diagnostics for these tumors. The morphologic spectrum of HLRCC-associated RCC is wide and histologic features, including tumor cells with prominent nucleoli, perinucleolar halos, and multiple architectural patterns within the same tumor, which are suggestive of this diagnosis. FH immunohistochemistry in conjunction with genetic counseling and germline FH testing are the important parameters for detection of this entity. These kidney tumors warrant prompt treatment as even smaller sized lesions can demonstrate aggressive behavior and systemic oncologic treatment in metastatic disease should, if possible, be part of a clinical trial. Screening procedures in HLRCC families should preferably be evaluated in large cohorts.

Renal collecting duct carcinoma: report of three cases and literature review / 中华泌尿外科杂志

Objective To investigate the clinicopathological features,diagnosis,differential diagnosis and prognosis of renal collecting duct carcinoma (CDC).Methods The clinical data of 3 patients with renal collecting duct carcinoma,during the period from January 2015 to November 2017,were retrospectively analyzed.3 patients were male with age ranged from 42 to 73 years old,mean of 57.5 years.Two lesions were located in the right kidney and one in the left kidney.Clinical manifestations were hematuria,abdominal mass and waist and abdomen pain.No laboratorial abnormality was found.CT examination showed the tumor diameter ranged from 3.1 to 5.1 cm,mean 3.9 cm.The tumors located in the medullary and renal pelvis with low density or mixed density.Those tumors extended to the peripheral of the kidney,which the boundary was unclear.During enhancement CT,the uneven enhancement effect could be observed.Radical nepheroectomy was performed in all patients.Results Postoperative pathological examination showed surface of incision was gray.The texture of tumor was hard.The invasive growth pattern could be noticed.Under the microscope,the tumors had small ducts and papillary structures of tubules with interstitial fibrosis and some sarcomatous differentiation.Immunohistochemical staining showed strong positive expression of vimentin,CK-L,CKpan and P504S,and positive expression of PAX-2,CK7 and EMA in different degrees.RCC,KSP,CD10,CD117,MOC-31 and TFE3 were all negative.All 3 cases were followed up from 1 to 15 months with an average of 6 months.One case was treated with chemotherapy because of extensive metastases after surgery.Chemotherapy was performed by dissolving 1 500 mg of fluorouracil in 1 000 ml of 5％ normal saline and instillation.It was administered once every 10-12 hours and once a day for 5 days in one cycle.However,the outcome was poor.1 patient died of tumor metastasis and recurrence 7 months after surgery.1 patient had no tumor remaining after surgery.Conclusions CDC is a very rare malignant epithelial neoplasm in kidney.It has obvious clinical symptoms,strong invasive pattern and poor prognosis.Imaging and ultrasonography only play an auxiliary role in diagnosis.CDC's unique histopathology is the main basis of diagnosis and differential diagnosis.

Collecting Duct Carcinoma (Bellini Duct Carcinoma) Presented as a Renal Cyst

Renal cysts are frequently seen in the general population. Most small simple renal cysts are managed by conservative treatment. A renal cell carcinoma (RCC) presenting as a renal cyst is extremely uncommon, and collecting duct carcinoma is a rare type of RCC. This report describes a collecting duct carcinoma initially presnted as a renal cyst. The patient was a 52-year-old man who had been diagnosed with a renal cyst in the left lower pole 8 years earlier but was not regularly follow-up. He presented with left flank pain and gross hematuria. Computed tomography revealed a heterogeneous enhanced mass in the left lower pole and multiple para-aortic lymph nodes. He underwent radical nephrectomy and lymph nodes dissection which confirmed collecting duct carcinoma with sarcomatoid differentiation.

Synchronous Clear Cell Renal Cell Carcinoma And Tubulocystic Renal Cell Carcinoma

Tubulocystic renal cell carcinoma (TCRCC) is a recently described rare subtype of RCC. To best of our knowledge less than 70 cases have been reported till date. The concurrent papillary RCC (PRCC) and TCRCC has been documented in literature, but the co-occurrence of clear cell RCC (CCRCC) and TCRCC is very rare. We are describing a rare case of incidentally detected TCRCC occurring with CCRCC in a 45 years old male who presented with high grade fever with chills and rigors. Grossly, there were two distinct tumors in the total nephrectomy specimen. The larger tumor displayed the histopathological features of CCRCC and the smaller tumor revealed the features of TCRCC.treatment in the present case.

Renal collecting duct carcinoma: imaging spectrum with CT and MRI / 中华泌尿外科杂志

Objective To summarize the experience of using CT and MRI to diagnose the renal collecting duct carcinoma.Methods From February 2005 to January 2012,10 cases with renal collecting duct carcinoma,confirmed by pathology,were reviewed retrospectively.The data contained 6 men and 4 women,whose age ranged from 21 to 62 years (mean age 48 years).The flank pain was complained by 7 cases,waist discomfort was complained by 3 cases.In urine laboratory test,positive urine erythrocytes (++++) were found in 6 cases.In 10 cases,7 cases accepted CT examination and 3 cases accepted MRI examination.The growth pattern,lesion location,dynamic enhanced scan phase of the tumor and the way of spreading and metastasis were analyzed based on those CT and MRI images.Results The lesions were located in the left kidney in 6 cases,located in the right kidney in 4 cases.The size of tumors ranged from 4.4 cm×5.8 cm to 7.2 cm× 7.4 cm (mean size 5.7 cm× 6.4 cm).The mass,located in the center of renal parenchyma with irregular shape,showed infiltrative growth pattern.The shape of kidney was normal,whereas the border line between cortex and medulla was indistinct.The tumor involved the renal cortex and medulla in 4cases and involved the renal cortex,medulla,pelvis simultaneously in 6 cases.Among 7 patients who accepted the CT scanning,the solid mass was revealed in 6 cases.On CT plain scanning,the masses demonstrated slightly low or equal density within flaky or patchy low-density necrosis.Two cases showed small punctate calcification within the mass.One case was solid and cystic mass,which the cystic part of the mass showed irregular shape of the liquid-density.Among 3 patients accepted MRI scanning,all masses showed solid characters.The substantial part showed slightly hypointense on T1WI and low signal intensity on T2WI.The necrotic foci demonstrated low signal intensity on T1WI and high signal on T2WI.Dynamic enhanced scan revealed mild to moderate enhanced in the substantive part.The density of signal was lower than the renal cortex and slightly higher than the renal medulla in corticomedullary phase.It enhanced continuously in parenchymal phase,but still lower than the renal parenchyma.It enhanced continuously in the delayed phase,while the cystic or necrotic lesions were not observed the enhancement.Renal artery was surrounded by the mass in 2 cases.Tumor embolus was found in the renal vein in 2 cases,9 cases were noticed with renal hilum and paraortic hyperlymphonodus.The thoracic and lumbar spinal metastasis was found in 1 case and adrenal metastasis was found in another case.All patients underwent radical nephrectomy,that pathological diagnosis was renal collecting duct carcinoma.Conclusions The CT and MRI imaging characteristics of renal collecting duct carcinoma can be described as the mass located in the center of renal parenchyma with the infiltrative growth pattern.In MRI image,it demonstrates low signal intensity on T2WI.And a mild continuously enhanced can be observed on dynamic enhanced scanning.Moreover,the tumor often involves renal hilum,perirenal fat capsule,paraortic lymph node,and shows the tendency of distant metastasis.

Collecting duct renal cell carcinoma with the syndrome of inappropriate antidiuresis: An autopsy case report.

A 57-year-old Japanese man visited our hospital with a moist cough. Chest radiographic imaging showed a left hilar shadow. Adenocarcinoma cells were found on cytologic screening of fresh sputum. Although multiple metastases including brain were detected, no tumor was observed in the kidneys. The patient underwent whole-brain irradiation and chemotherapy for advanced-stage lung cancer. One month before his death, carcinomatous meningitis was detected. Hyponatremia, hypo-osmolality, and hypertonic urine suggested the syndrome of inappropriate antidiuresis. Restricting water intake improved the hyponatremia; however, he developed fever and hematuria. Despite systemic administration of an antibacterial drug, he died. Primary tumor in the lung was absent, but adenocarcinoma of the right kidney was evident on autopsy. Lectin histochemical analysis of the carcinoma revealed its distal nephron origin, confirming collecting duct carcinoma. Severe carcinomatous meningitis, which is possibly caused the syndrome of inappropriate antidiuresis, was observed, with no cancer involvement of the pituitary gland and hypothalamus.

Metastatic collecting duct (Bellini duct) carcinoma: A case report / 대한내과학회지

Renal cell carcinoma accounts for 2.6% of all cancer, and most renal cell carcinoma has a clear cell origin. Bellini duct carcinoma, which arises from collecting duct cells (Bellini cells), is a rare type of renal cell carcinoma, constituting less than 1% of all renal cell carcinoma. The prognosis of Bellini duct carcinoma is very poor, and more than 60% of the patients die within 2 years of diagnosis. There is no consensus regarding the optimal treatment. We report a case of Bellini duct carcinoma in a 53-year-old male with multiple lung and liver metastases. The patient was treated with eight cycles of M-VAC (methotrexate, vincristine, doxorubicin, and cisplatin) combination chemotherapy. The patient currently shows a radiological partial response without disease progression 10 months after the chemotherapy.

Metastatic collecting duct (Bellini duct) carcinoma: A case report / 대한내과학회지

Renal cell carcinoma accounts for 2.6% of all cancer, and most renal cell carcinoma has a clear cell origin. Bellini duct carcinoma, which arises from collecting duct cells (Bellini cells), is a rare type of renal cell carcinoma, constituting less than 1% of all renal cell carcinoma. The prognosis of Bellini duct carcinoma is very poor, and more than 60% of the patients die within 2 years of diagnosis. There is no consensus regarding the optimal treatment. We report a case of Bellini duct carcinoma in a 53-year-old male with multiple lung and liver metastases. The patient was treated with eight cycles of M-VAC (methotrexate, vincristine, doxorubicin, and cisplatin) combination chemotherapy. The patient currently shows a radiological partial response without disease progression 10 months after the chemotherapy.

Carcinoma renal dos ductos de Bellini / Bellini duct carcinoma of the Kidney

Two types primary epithelial tumours of the kidney have been distinguished, such as renal cell carcinoma (hypernephroma or Grawitz) deriving from proximal tubules and carcinoma arising in the urothelium of the kidney's collecting system. Mancilla-Jimenez e cols were the first to describe in 1976 an atypical papillary carcinoma of the kidney deriving from collecting duct system-Bellini duct carcinoma (BDC). In the World Healthy Organization classification it is listed as a rare carcinoma ( 1 percent of the renal malignancies) originating in the renal medulla. Histologic examination shows both tubular and papillary architeture, which can lead to misinterpretation as renal cell or transitional cell carcinoma. Renal cell carcinoma originates from the metanephrogenic blastema and collecting duct carcinoma derived embryologicaly from the mesonephron Wolff duct. Renal cell carcinoma has been shown to express both cytokeratins and vimetin, whereas the distal convoluted tubule expresses only cytokeratins. BDC can be considered as a renal malignancy with a very bad prognosis compared to the other renal cell carcinoma. The best treatment is radical nephrectomy. A case of BDC is reported in a young black man, 27 year old with only history of light left back pain. Ultrasound and other image examinations showed a tumour about 6 cm in the middle and low left kidney. Patient was submitted to extraperitoneal radical nephectomy. Microscopic evaluation revealed kidney's collecting duct carcinoma with metastasis on two retroperitoneal lymphy nodes.

A Case of Collecting Duct Carcinoma of Kidney / 대한비뇨기과학회지

Most renal carcinomas are thought to originate from the epithelial cells of proximal convoluted tubules in the renal cortex. Collecting duct carcinoma is a recently recognized histological variety of renal cell carcinoma considered to arise from the epithelium of the collecting ducts. It is important to distinguish the collecting duct carcinoma from ordinary renal cell carcinoma, because which has an aggressive clinical course with early metastasis and death. But in patients, the natural course of the disease and its response to treatment have not been clearly established. Herein we report a case of collecting duct carcinoma of kidney in 38-year-old woman who had generalized edema and left flank dull pain. The preoperative diagnosis was left renal cell carcinoma on physical examination and radiologic finding, and left radical nephrectomy was done.

A case of collecting duct carcinoma of the kidney / 대한비뇨기과학회지

Collecting duct carcinoma is an unusual variant of renal cell carcinoma, which is originated from the collecting tubules of the kidney. The typical histological appearance is that of a papillary adenocarcinoma with infiltrating tubules and desmoplastic reaction. And there is mainly tubulo-papillary. structure in histologic examination. We report a case of collecting duct carcinoma of kidney in a 47 years old female, which was managed by radical nephrectomy.