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      Synchronous sporadic bilateral multiple chromophobe renal cell carcinoma accompanied by a clear cell carcinoma and a cyst: A case report

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          Abstract

          BACKGROUND

          Renal cell carcinomas are usually unilateral. However, they are bilateral in 2% to 4% of sporadic cases and is considerably more common in familial cases. Synchronous sporadic bilateral multiple chromophobe renal cell carcinoma (CHRCC) with different subtypes is rare.

          CASE SUMMARY

          In this case report, we describe a case of synchronous bilateral CHRCC with two histological variants, accompanied by a clear cell carcinoma and a cyst in a 50-year-old male. The patient underwent retroperitoneal laparoscopic bilateral nephron-sparing surgery and there was no serious postoperative renal dysfunction.

          CONCLUSION

          We report a rare case of synchronous bilateral CHRCC with two histological variants associated with a clear cell carcinoma and a cyst.

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          Most cited references27

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          Review of renal cell carcinoma and its common subtypes in radiology.

          Gavin Low, Safwat Girgis, Zaahir Moloo … (2016)
          Representing 2%-3% of adult cancers, renal cell carcinoma (RCC) accounts for 90% of renal malignancies and is the most lethal neoplasm of the urologic system. Over the last 65 years, the incidence of RCC has increased at a rate of 2% per year. The increased incidence is at least partly due to improved tumor detection secondary to greater availability of high-resolution cross-sectional imaging modalities over the last few decades. Most RCCs are asymptomatic at discovery and are detected as unexpected findings on imaging performed for unrelated clinical indications. The 2004 World Health Organization Classification of adult renal tumors stratifies RCC into several distinct histologic subtypes of which clear cell, papillary and chromophobe tumors account for 70%, 10%-15%, and 5%, respectively. Knowledge of the RCC subtype is important because the various subtypes are associated with different biologic behavior, prognosis and treatment options. Furthermore, the common RCC subtypes can often be discriminated non-invasively based on gross morphologic imaging appearances, signal intensity on T2-weighted magnetic resonance images, and the degree of tumor enhancement on dynamic contrast-enhanced computed tomography or magnetic resonance imaging examinations. In this article, we review the incidence and survival data, risk factors, clinical and biochemical findings, imaging findings, staging, differential diagnosis, management options and post-treatment follow-up of RCC, with attention focused on the common subtypes.
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            MRI features of renal oncocytoma and chromophobe renal cell carcinoma.

            Nicole Hindman, Genghis E Niver, J. Babb … (2010)
            The purpose of this study was to retrospectively describe the MRI features of the pathologically related entities renal oncocytoma and chromophobe renal cell carcinoma (RCC). Twenty-eight cases of histologically proven renal oncocytoma and 15 of chromophobe RCC evaluated with preoperative MRI from January 2003 through June 2009 at our institution were independently reviewed for an array of MRI features by two radiologists blinded to the final histopathologic diagnosis. These features were tabulated and compared between chromophobe RCC and renal oncocytoma by use of the Mann-Whitney test and binary logistic regression. Renal oncocytoma and chromophobe RCC showed no significant difference in size or any of 16 qualitative imaging features (p = 0.0842-1.0, reader 1; p = 0.0611-1.0, reader 2). Microscopic fat, hemorrhage, cysts, infiltrative margins, perinephric fat invasion, renal vein invasion, enhancement homogeneity, and hypervascularity were each observed in less than 20% of cases by both readers. A central scar and segmental enhancement inversion (a recently described finding in which early contrast-enhanced images show relatively more enhanced and less enhanced intralesional components with inversion of their relative enhancement on later images) were observed by both readers in at least 10% of cases of both renal oncocytoma and of chromophobe RCC with no significant difference between the two entities (p = 0.2092-0.2960). We have presented the largest series to date of the MRI features of both renal oncocytoma and chromophobe RCC. These related entities exhibited similar findings, and no MRI features were reliable in distinguishing between them.
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              Imaging features of solid renal masses

              Massimo Galia, Domenico Albano, Alberto Bruno … (2017)
              The widespread use of abdominal imaging techniques has increased the detection of solid renal masses over the past years. Imaging plays a crucial role in the management and surveillance and in determining which lesions need treatment. The “classical angiomyolipoma” is the only benign solid renal mass that can be characterized with confidence by imaging through the detection of a fat-containing lesion without calcifications. There is a large overlap of imaging features between benign and malignant renal masses that often makes difficult a correct characterization of these lesions. In this review, we discuss the imaging features of the main solid renal masses that may suggest a likely benign diagnosis.
              Article 0 comments Cited 26 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Fan Yang
                Zi-Chen Zhao
                A-Jin Hu
                Peng-Fei Sun
                Bin Zhang
                Ming-Chuan Yu
                Juan Wang
                Journal
                Journal ID (nlm-ta): World J Clin Cases
                Journal ID (publisher-id): WJCC
                Title: World Journal of Clinical Cases
                Publisher: Baishideng Publishing Group Inc
                ISSN (Electronic): 2307-8960
                Publication date (Print): 26 July 2020
                Publication date (Electronic): 26 July 2020
                Volume: 8
                Issue: 14
                Pages: 3064-3073
                Affiliations
                Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
                Department of Urinary Surgery, Peking University Shougang Hospital, Beijing 100144, China
                Department of Pathology, Peking University Shougang Hospital, Beijing 100144, China
                Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
                Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China. zhangbinsgyy@ 123456126.com
                Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
                Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
                Author notes

                Author contributions: Zhao ZC was the patient’s surgeon, reviewed the literature, and contributed to manuscript drafting; Hu AJ performed the pathology analyses and interpretation and contributed to manuscript drafting; Yu MC and Wang J analyzed and interpreted the imaging findings; Yang F and Sun PF reviewed the literature and contributed to the manuscript; Yang F and Zhang B were responsible for the revision of the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.

                Corresponding author: Bin Zhang, BM BCh, Associate Professor, Department of Radiology, Peking University Shougang Hospital, No. 9, Jinyuanzhuang Road, Shijingshan District, Beijing 100144, China. zhangbinsgyy@ 123456126.com

                Article
                Other ID: jWJCC.v8.i14.pg3064
                DOI: 10.12998/wjcc.v8.i14.3064
                PMC ID: 7385615
                SO-VID: 407a0ca7-2858-475e-8df0-bf547035569a
                Copyright © ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                Date received : 19 March 2020
                Date revision received : 1 May 2020
                Date accepted : 25 June 2020
                Categories
                Subject: Case Report

                Keywords: bilateral sporadic renal cell carcinoma,chromophobe renal cell carcinoma,multiple tumors,laparoscopic partial nephrectomy,kidney,case report
                Data availability:
                Keywords: bilateral sporadic renal cell carcinoma, chromophobe renal cell carcinoma, multiple tumors, laparoscopic partial nephrectomy, kidney, case report

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