Papillary renal cell carcinoma: 14 case report with literature review / 中华泌尿外科杂志

ABSTRACT

Objective To study the characteristics of different papillary renal cell carcinoma (PRCC)subtypes and their prognosis after nephrectomy.Methods Clinical data of 14 PRCC patients(7 males,7 females)with ages ranging from 20-77 in our institute from 2005 to 2011 were retrospectively reviewed.There were 5 tumors in the left kidney and 9 tumors in the right kidney.The average maximum tumor diameter was 3.8(1.6-7.8)cm.Patients presented with gross hematuria(n =3),flank pain(n =3),palpable abdominal mass(n =1)or asymptomatic(n =7).The TNM stages were 8 T1aN0M0,2 T1bN0M0,1 T1aN0M1,1 T2aN0M0,1 T3aN0M0 and 1 T3aN1 M0.Six patients were treated with radical nephrectomy,8 cases were treated with partial nephrectomy.Results There were 6 type Ⅰ and 8 type Ⅱ PRCCs cases.In pathology,type Ⅰ PRCC showed papillae covered by small cells with scanty basophilic cytoplasm,and arranged in a single layer on the papillary basement membrane with low nuclear grade.Type Ⅱ PRCC was composed of cells with higher nuclear grade,abundant eosinophilic cytoplasm,and pseudostratified nuclei on papillary cores.There were 12 well-differentiated cases,2 moderate-differentiated cases and no poorly differentiated case.Follow-up was carried out from 12to 80 months.During the follow-up,1 patient with type Ⅰ PRCC developed multiple lung metastases 26 month after surgery and deteriorated into hepatic and bone metastases at 34 month after surgery.We offered the patient with targeted therapy and the patient was still alive.There was 1 type Ⅱ PRCC patient died with multiple metastases at 42 month after surgery.Others were still alive without local recurrence and metastasis.Conclusions PRCC is not a common subtype of renal cell carcinoma in China.Early stage PRCC patient would achieve good prognosis after treated with nephrectomy.Targeted therapy is a good treatment option for metastatic papillary renal cell carcinoma patients.