We report the case of a 67-year-old female who presented with a large renal mass. Gross examination of the nephrectomy specimen demonstrated a 6-cm renal mass that invaded into the renal sinus and perinephric fat. His...We report the case of a 67-year-old female who presented with a large renal mass. Gross examination of the nephrectomy specimen demonstrated a 6-cm renal mass that invaded into the renal sinus and perinephric fat. Histologic examination revealed two distinct tumor types. The first type was a conventional(clear cell) renal cell carcinoma that was of low nuclear grade and comprised the minority of the overall tumor. The second type was a high-grade collecting duct carcinoma with glandular/tubular differentiation and composed the majority of the tumor. Immunohistochemical studies demonstrated distinctive patterns of the two tumor types, thus confirming two distinct lineages. Five months postoperatively, the patient developed metastasis to the lungs and right hilar lymph node region. A fine needle aspiration of a lung nodule demonstrated a metastatic, poorly differentiated carcinoma, similar to the collecting duct carcinoma component in the kidney. Collision tumors of the kidney are rare with fewer than 10 cases reported in the literature. Our report further expands the spectrum of this rare phenomenon.展开更多
Objectives: To evaluate treatment and prognosis of collecting duct renal cell carcinoma (CDRCC) in three institutions. Methods: The data of CDRCC patients were collected retrospectively from 3 participating institutio...Objectives: To evaluate treatment and prognosis of collecting duct renal cell carcinoma (CDRCC) in three institutions. Methods: The data of CDRCC patients were collected retrospectively from 3 participating institutions. Results: A total of 24 patients were identified in 3 institutions with an incidence of 0.5% - 0.6%. Among them, the median age was 63.0 years and male gender was predominant (66.7%). At least 45.7% (11/24) of the patients were symptomatic at presentation. Moreover, distant metastasis at initial diagnosis was present in 13 patients (54.2%) and 6 patients (25.0%) developed distant metastasis during the course of disease. Almost all these patients were at high stage (87.5%) and poorly differentiated (79.2%). Besides, nodal involvement and major vein extension were observed in 14 (58.3%) and 10 (41.7%) patients, respectively. All the patients in this cohort underwent surgery with a median cancer specific survival of 11.3 months. Of the 14 patients with chemotherapy, gemcitabine/cisplatin was dominantly given in 6 patients (42.9%). Conclusions: CDRCC is rarely seen. Most of CDRCC patients had advanced stage, high nuclear grade, regional nodal involvement, distant metastasis at presentation and consequent poor prognosis. To date, no standard protocol for the treatment of CDRCC exists. Current standard in systemic therapy of CDRCC is chemotherapy with gemcitabine and cisplatin.展开更多
文摘We report the case of a 67-year-old female who presented with a large renal mass. Gross examination of the nephrectomy specimen demonstrated a 6-cm renal mass that invaded into the renal sinus and perinephric fat. Histologic examination revealed two distinct tumor types. The first type was a conventional(clear cell) renal cell carcinoma that was of low nuclear grade and comprised the minority of the overall tumor. The second type was a high-grade collecting duct carcinoma with glandular/tubular differentiation and composed the majority of the tumor. Immunohistochemical studies demonstrated distinctive patterns of the two tumor types, thus confirming two distinct lineages. Five months postoperatively, the patient developed metastasis to the lungs and right hilar lymph node region. A fine needle aspiration of a lung nodule demonstrated a metastatic, poorly differentiated carcinoma, similar to the collecting duct carcinoma component in the kidney. Collision tumors of the kidney are rare with fewer than 10 cases reported in the literature. Our report further expands the spectrum of this rare phenomenon.
文摘Objectives: To evaluate treatment and prognosis of collecting duct renal cell carcinoma (CDRCC) in three institutions. Methods: The data of CDRCC patients were collected retrospectively from 3 participating institutions. Results: A total of 24 patients were identified in 3 institutions with an incidence of 0.5% - 0.6%. Among them, the median age was 63.0 years and male gender was predominant (66.7%). At least 45.7% (11/24) of the patients were symptomatic at presentation. Moreover, distant metastasis at initial diagnosis was present in 13 patients (54.2%) and 6 patients (25.0%) developed distant metastasis during the course of disease. Almost all these patients were at high stage (87.5%) and poorly differentiated (79.2%). Besides, nodal involvement and major vein extension were observed in 14 (58.3%) and 10 (41.7%) patients, respectively. All the patients in this cohort underwent surgery with a median cancer specific survival of 11.3 months. Of the 14 patients with chemotherapy, gemcitabine/cisplatin was dominantly given in 6 patients (42.9%). Conclusions: CDRCC is rarely seen. Most of CDRCC patients had advanced stage, high nuclear grade, regional nodal involvement, distant metastasis at presentation and consequent poor prognosis. To date, no standard protocol for the treatment of CDRCC exists. Current standard in systemic therapy of CDRCC is chemotherapy with gemcitabine and cisplatin.
