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Osteoclast-like giant cell carcinoma of the distal ureter.

Park H - Korean J Urol (2011)

Bottom Line: Most cases found in the renal pelvis and bladder are associated with either an in situ urothelial malignancy or a conventional high-grade urothelial carcinoma.These malignancies tend to be associated with a poor prognosis and disease course.Pathologic examination showed OGC carcinoma of the right distal ureter.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, School of Medicine, Kangwon National University, Chuncheon, Korea.

ABSTRACT
Extraskeletal osteoclast-like giant cell (OGC) tumors are uncommon and have mainly been found in the breast and pancreas. OGC neoplasms of the urinary tract are extremely rare. Most cases found in the renal pelvis and bladder are associated with either an in situ urothelial malignancy or a conventional high-grade urothelial carcinoma. These malignancies tend to be associated with a poor prognosis and disease course. To our knowledge, no cases of OGC tumors of the distal ureter only have been published. Here, we present the case of a 76-year-old man who underwent hand-assisted laparoscopic nephroureterectomy because of painless gross hematuria with right flank pain. Pathologic examination showed OGC carcinoma of the right distal ureter. No local tumor recurrence or distant metastasis was found at the 5-month follow-up.

No MeSH data available.


Related in: MedlinePlus

Pathologic examination shows osteoclast-like giant cell carcinoma (H&E, ×200).
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Figure 3: Pathologic examination shows osteoclast-like giant cell carcinoma (H&E, ×200).

Mentions: Ureteroscopy showed a nodular lesion obstructing the distal ureter. A complete right hand-assisted laparoscopic nephroureterectomy was performed. Grossly, several small and large simple cysts were observed in the renal cortex, of which the largest measured 3×2 cm. The pelvis was cystically dilated and was shown to contain clear fluid. The distal end area was dilated, and an irregular polypoid mass measuring 5×1.5×1.2 cm was identified 2 cm from the bladder cuff (Fig. 2). Microscopically, a population of mononuclear cells with numerous interspersed multinucleated giant cells were observed. The mononuclear cells contained round- to oval-shaped nuclei with vesicular chromatin, inconspicuous nucleoli, moderate nuclear clearing, and mild nuclear pleomorphism. The cytoplasm was amphophilic, and cytoplasmic vacuolation was observed in the focal cells. Approximately 2 mitoses per 10 high-power fields were observed. OGCs had multiple round-to-oval, bland-appearing nuclei ranging from 4 to 34 in number. Their cytoplasm was eosinophilic and had well-demarcated cellular boundaries (Fig. 3). Areas of conventional high-grade urothelial carcinoma were noted adjacent to the tumor. The tumor invaded focally into the periureteric adipose tissue and was categorized as American Joint Committee on Cancer stage pT3NxMx. Immunohistologic examination showed that the multinucleated giant cells were positive for CD68, CD45, epithelial membrane antigen (EMA), vimentin, and cytokeratin (cytoplasmic but not nuclear staining) and negative for desmin and CD31 (Fig. 4). At the 5-month postsurgical follow-up, the patient was doing well, had no evidence of disease recurrence, and had a serum creatinine level of 2.5 ng/ml.


Osteoclast-like giant cell carcinoma of the distal ureter.

Park H - Korean J Urol (2011)

Pathologic examination shows osteoclast-like giant cell carcinoma (H&E, ×200).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3037510&req=5

Figure 3: Pathologic examination shows osteoclast-like giant cell carcinoma (H&E, ×200).
Mentions: Ureteroscopy showed a nodular lesion obstructing the distal ureter. A complete right hand-assisted laparoscopic nephroureterectomy was performed. Grossly, several small and large simple cysts were observed in the renal cortex, of which the largest measured 3×2 cm. The pelvis was cystically dilated and was shown to contain clear fluid. The distal end area was dilated, and an irregular polypoid mass measuring 5×1.5×1.2 cm was identified 2 cm from the bladder cuff (Fig. 2). Microscopically, a population of mononuclear cells with numerous interspersed multinucleated giant cells were observed. The mononuclear cells contained round- to oval-shaped nuclei with vesicular chromatin, inconspicuous nucleoli, moderate nuclear clearing, and mild nuclear pleomorphism. The cytoplasm was amphophilic, and cytoplasmic vacuolation was observed in the focal cells. Approximately 2 mitoses per 10 high-power fields were observed. OGCs had multiple round-to-oval, bland-appearing nuclei ranging from 4 to 34 in number. Their cytoplasm was eosinophilic and had well-demarcated cellular boundaries (Fig. 3). Areas of conventional high-grade urothelial carcinoma were noted adjacent to the tumor. The tumor invaded focally into the periureteric adipose tissue and was categorized as American Joint Committee on Cancer stage pT3NxMx. Immunohistologic examination showed that the multinucleated giant cells were positive for CD68, CD45, epithelial membrane antigen (EMA), vimentin, and cytokeratin (cytoplasmic but not nuclear staining) and negative for desmin and CD31 (Fig. 4). At the 5-month postsurgical follow-up, the patient was doing well, had no evidence of disease recurrence, and had a serum creatinine level of 2.5 ng/ml.

Bottom Line: Most cases found in the renal pelvis and bladder are associated with either an in situ urothelial malignancy or a conventional high-grade urothelial carcinoma.These malignancies tend to be associated with a poor prognosis and disease course.Pathologic examination showed OGC carcinoma of the right distal ureter.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, School of Medicine, Kangwon National University, Chuncheon, Korea.

ABSTRACT
Extraskeletal osteoclast-like giant cell (OGC) tumors are uncommon and have mainly been found in the breast and pancreas. OGC neoplasms of the urinary tract are extremely rare. Most cases found in the renal pelvis and bladder are associated with either an in situ urothelial malignancy or a conventional high-grade urothelial carcinoma. These malignancies tend to be associated with a poor prognosis and disease course. To our knowledge, no cases of OGC tumors of the distal ureter only have been published. Here, we present the case of a 76-year-old man who underwent hand-assisted laparoscopic nephroureterectomy because of painless gross hematuria with right flank pain. Pathologic examination showed OGC carcinoma of the right distal ureter. No local tumor recurrence or distant metastasis was found at the 5-month follow-up.

No MeSH data available.


Related in: MedlinePlus