Renal Cancer Diagnosed by Noninvasive Methods from Body Fluids by Quantitative Methylation-Specific PCR(qMSP).

BACKGROUND: Renal cell carcinoma (RCC) represents the 9th most common malignancy in the world, having an incidence peak in the range of 60 to 70 years of age. Most of these malignancies are detected in an advanced stage. Thus, there is an urgent need for developing new tools composed of biomarkers. METHODS: In the present study we measured the promoter methylation of the Ras association domain family 1A gene (RASSF1A) by quantitative methylation-specific PCR (qMSP) in paired urine samples from 13 RC patients and from 13 corresponding controls. RESULTS: In RC patients, only 2 of 13 (15.4%) were unmethylated, whereas 11 of 13 (84.6%) were methylated. In the control group all the subjects were unmethylated. We analyzed the receiver operating curve (ROC) and obtained a sensitivity of 84.6% and a specificity of 100%, respectively, for the RASSF1A gene. The area under the curve (AUC) was of 0.923. CONCLUSIONS: Being involved in the initiation and progression of renal carcinogenesis, RASSF1A gene could aid as a biomarker in the early detection of renal cancer, its prognosis, and in its follow-up.

Right lump kidney with varied vasculature and urinary system revealed by multidetector computed tomographic (MDCT) angiography.

Renal ectopia also known as ectopic kidney is an embryological renal anomaly characterised by abnormal anatomical location of one or both of the kidneys. This can occur in various forms such as (1) crossed fused renal ectopia, (2) ectopic thoracic kidney and (3) pelvic kidneys. The lump kidney is one of the six variations of crossed fused ectopic kidney. Throughout life, the patient may remain asymptomatic, however, symptomatic patients may present with minor traumatic injuries due to the abnormal location or normal kidney pathologies. During normal embryological development, there is cephalic migration during which the kidneys ascend to their normal retroperitoneal location; therefore, an ectopic location is as a result of arrested migration. During this embryological development the kidney has multiple aorto-illiac branches, which degenerate when the kidney reaches its normal location. Here they develop new renal branches from the aorta and during an arrested ascent the ectopic kidney tends to retain some of the older aorto-iliac vessels. Hence, the arterial supply and the veineux drainage are grossly abnormal, reflecting the metanephric malascent and the primitive vascular arrangement. The collecting systems also present with important anatomical variations. We present an extremely rare case of right lump kidney with six renal arteries, two renal veins and two duplicated pelvicalyceal systems.

Left crossed fused renal ectopia L-shaped kidney type, with double nutcracker syndrome (anterior and posterior).

Crossed fused renal ectopia (CFRE) is the second most common fusion anomalies (FAs) of the kidneys after horseshoe kidney. Crossed fused renal ectopia (CFRE) results from one kidney crossing over to the opposite side and subsequent fusion of the parenchyma of the two kidneys. We report, by multidetector-row computed tomography (MDCT) angiography, an extremely rare case of a left CFRE (L-shaped kidney type), consisting of multiple renal arteries (one main renal artery for the upper renal parenchyma, and three renal arteries (one main and two additional) for the lower renal parenchyma) and two left renal veins, which produced a double nutcracker syndrome (both anterior and posterior). The L-shaped left kidney has a maximum length of 18.5 cm, a maximum width of 10.2 cm, and a maximum thickness of 5.3 cm. The upper pole of the kidney is located at the level of the lower third of T12 vertebral body (4.6 cm left to the mediosagittal plan); the lower pole is located along the lower half of the L5 vertebral body (1.5 cm left to the mediosagittal plan). The following case will focus on the relevant anatomy, embryology, and the clinical significance of this entity.