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Comprehensive clinical and pathological analysis of aggressive renal epithelioid angiomyolipoma: report of three cases.

Luo J, Liu B, Wang Y, Li J, Wang P, Chen J, Wang C - Onco Targets Ther (2014)

Bottom Line: It can occur in patients with or without tuberous sclerosis.At times, the lesions may extend into the renal vein and inferior vena cava or metastasize to other organs such as the lung and liver.To clarify the biological nature of EAML, three specific cases that we encountered in clinical practice are analyzed and reported in detail.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Zhejiang University, Zhejiang, People's Republic of China.

ABSTRACT
Renal angiomyolipoma (AML) is recognized as a benign hamartomatous lesion arising in the kidney with no obvious malignant potential. However, epithelioid AML (EAML), a rare variant of AML, is potentially malignant, with aggressive clinical features. It can occur in patients with or without tuberous sclerosis. Because EAML may mimic renal cell carcinoma in imaging studies, differentiation of this tumor from renal cell carcinoma preoperatively is difficult. At times, the lesions may extend into the renal vein and inferior vena cava or metastasize to other organs such as the lung and liver. To clarify the biological nature of EAML, three specific cases that we encountered in clinical practice are analyzed and reported in detail.

No MeSH data available.


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Histopathological findings of metastatic lesion in the lung.Notes: The morpholgic features of lung lesion were consistent with the features of the renal lesion (hematoxylin and eosin; magnification, ×200).
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f4-ott-7-823: Histopathological findings of metastatic lesion in the lung.Notes: The morpholgic features of lung lesion were consistent with the features of the renal lesion (hematoxylin and eosin; magnification, ×200).

Mentions: A 55-year-old woman was hospitalized with left flank pain for 3 months. Sonography revealed a solid mass (7.5 cm × 7.0 cm × 6.7 cm) in the left kidney, and radical nephrectomy was performed in May 1994. The diagnosis of renal cell carcinoma (RCC) was made without immunohistochemical examination. Seven years later, CT showed a mass of 8.0 cm × 7.0 cm × 6.5 cm in the lower pole, with another tumor of 1.5 cm in the upper pole of the right lung. Lobectomy of the right lung was then performed. The morphologic features of lung lesion (Figure 4) were consistent with the features of the renal lesion (Figure 5). Both renal and pulmonary tumors were reevaluated by immunohistochemical assays. The results showed that the tumor cells of both specimens were positive for vimentin and HMB-45, but they were negative for cytokeratin and S-100 protein. The corrected diagnosis of malignant renal EAML with pulmonary metastases was made. No chemotherapy or radiotherapy was administered postoperatively. The patient died as a result of respiratory failure due to multiple pulmonary metastases about 15 years after nephrectomy. Partial information of case 3 was reported in preliminary communications.7


Comprehensive clinical and pathological analysis of aggressive renal epithelioid angiomyolipoma: report of three cases.

Luo J, Liu B, Wang Y, Li J, Wang P, Chen J, Wang C - Onco Targets Ther (2014)

Histopathological findings of metastatic lesion in the lung.Notes: The morpholgic features of lung lesion were consistent with the features of the renal lesion (hematoxylin and eosin; magnification, ×200).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4043816&req=5

f4-ott-7-823: Histopathological findings of metastatic lesion in the lung.Notes: The morpholgic features of lung lesion were consistent with the features of the renal lesion (hematoxylin and eosin; magnification, ×200).
Mentions: A 55-year-old woman was hospitalized with left flank pain for 3 months. Sonography revealed a solid mass (7.5 cm × 7.0 cm × 6.7 cm) in the left kidney, and radical nephrectomy was performed in May 1994. The diagnosis of renal cell carcinoma (RCC) was made without immunohistochemical examination. Seven years later, CT showed a mass of 8.0 cm × 7.0 cm × 6.5 cm in the lower pole, with another tumor of 1.5 cm in the upper pole of the right lung. Lobectomy of the right lung was then performed. The morphologic features of lung lesion (Figure 4) were consistent with the features of the renal lesion (Figure 5). Both renal and pulmonary tumors were reevaluated by immunohistochemical assays. The results showed that the tumor cells of both specimens were positive for vimentin and HMB-45, but they were negative for cytokeratin and S-100 protein. The corrected diagnosis of malignant renal EAML with pulmonary metastases was made. No chemotherapy or radiotherapy was administered postoperatively. The patient died as a result of respiratory failure due to multiple pulmonary metastases about 15 years after nephrectomy. Partial information of case 3 was reported in preliminary communications.7

Bottom Line: It can occur in patients with or without tuberous sclerosis.At times, the lesions may extend into the renal vein and inferior vena cava or metastasize to other organs such as the lung and liver.To clarify the biological nature of EAML, three specific cases that we encountered in clinical practice are analyzed and reported in detail.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Zhejiang University, Zhejiang, People's Republic of China.

ABSTRACT
Renal angiomyolipoma (AML) is recognized as a benign hamartomatous lesion arising in the kidney with no obvious malignant potential. However, epithelioid AML (EAML), a rare variant of AML, is potentially malignant, with aggressive clinical features. It can occur in patients with or without tuberous sclerosis. Because EAML may mimic renal cell carcinoma in imaging studies, differentiation of this tumor from renal cell carcinoma preoperatively is difficult. At times, the lesions may extend into the renal vein and inferior vena cava or metastasize to other organs such as the lung and liver. To clarify the biological nature of EAML, three specific cases that we encountered in clinical practice are analyzed and reported in detail.

No MeSH data available.


Related in: MedlinePlus