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Concurrent occurrence of renal cell carcinoma with rhabdoid features in a married couple: a case report.

Matsumoto R, Shinohara N, C-Hatanaka K, Kuroda N, Tsuchiya K, Maruyama S, Abe T, Nonomura K - BMC Res Notes (2015)

Bottom Line: Bone metastasis occurred 12 months postoperatively, but he died of an unrelated cause 18 months after surgery.Concurrent occurrence of RCC with rhabdoid features may not to be coincidental.Although further studies are warranted, asbestos exposure may contribute to the etiology of clear cell RCC with rhabdoid features.

View Article: PubMed Central - PubMed

Affiliation: Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, North-15, West-7, Sapporo, Japan. ryu-matsumoto@amber.plala.or.jp.

ABSTRACT

Background: Renal cell carcinoma (RCC) with rhabdoid features is a rare histology and exhibits clinically aggressive behavior. We report a case of a married couple in whom RCC with rhabdoid features concurrently occurred. The rarity of this event suggests that environmental factors may contribute to the etiology of RCC with rhabdoid features.

Case presentation: A 76-year-old Japanese woman was diagnosed with a hypervascular mass in the right kidney and tumor thrombus extending into the right atrium by enhanced computed tomography (CT). She underwent radical nephrectomy and tumor thrombectomy following systemic therapy with the tyrosine kinase inhibitor sunitinib. The histological evaluation denoted clear cell RCC with rhabdoid features. The patient died of cancer 12 months postoperatively. A 76-year-old man, her husband, presented with gross hematuria 2 weeks after his wife had undergone surgery. He had a long history of asbestos exposure. An abdominal CT scan revealed a hypervascular mass in the right kidney and tumor thrombus extending into the inferior vena cava. He also underwent radical nephrectomy and tumor thrombectomy. The histological evaluation also showed clear cell RCC with rhabdoid features. Bone metastasis occurred 12 months postoperatively, but he died of an unrelated cause 18 months after surgery.

Conclusion: Concurrent occurrence of RCC with rhabdoid features may not to be coincidental. Although further studies are warranted, asbestos exposure may contribute to the etiology of clear cell RCC with rhabdoid features.

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Pathological findings in Case 2 (the husband of Case 1). (a) Histological section displaying typical clear cell RCC area, (b) neoplastic cells with rhabdoid features, (c) spindle neoplastic cells, and (d) strong cytoplasmic positivity for vimentin. (e) BAP1 immunohistochemistry showed loss of nuclear staining in tumor cells.
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Fig3: Pathological findings in Case 2 (the husband of Case 1). (a) Histological section displaying typical clear cell RCC area, (b) neoplastic cells with rhabdoid features, (c) spindle neoplastic cells, and (d) strong cytoplasmic positivity for vimentin. (e) BAP1 immunohistochemistry showed loss of nuclear staining in tumor cells.

Mentions: In December 2009, the above patient’s 76-year-old husband with gross hematuria and was referred to our hospital. Enhanced CT scans of the abdomen revealed an 80 mm mass in his right kidney and tumor thrombus into the inferior vena cava (Figure 1b). In January 2010, right radical nephrectomy with vena caval thrombectomy was performed without any intraoperative or postoperative complications. Histological evaluation of the tumor denoted Fuhrman nuclear grade 4 clear cell RCC with rhabdoid features and sarcomatoid change (Figure 3a, b and c). Immunohistochemically, the rhabdoid cells were positive for vimentin, whereas the tumor cell nuclei were mostly negative for BAP1 (Figure 3d and e). In January 2011, the patient complained of lower back pain and neurological disorder of the lower extremity. Magnetic resonance imaging revealed vertebral metastasis at the L1 level and compression of the spinal cord. The patient died of an unrelated cause in April 2011.Figure 3


Concurrent occurrence of renal cell carcinoma with rhabdoid features in a married couple: a case report.

Matsumoto R, Shinohara N, C-Hatanaka K, Kuroda N, Tsuchiya K, Maruyama S, Abe T, Nonomura K - BMC Res Notes (2015)

Pathological findings in Case 2 (the husband of Case 1). (a) Histological section displaying typical clear cell RCC area, (b) neoplastic cells with rhabdoid features, (c) spindle neoplastic cells, and (d) strong cytoplasmic positivity for vimentin. (e) BAP1 immunohistochemistry showed loss of nuclear staining in tumor cells.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4302605&req=5

Fig3: Pathological findings in Case 2 (the husband of Case 1). (a) Histological section displaying typical clear cell RCC area, (b) neoplastic cells with rhabdoid features, (c) spindle neoplastic cells, and (d) strong cytoplasmic positivity for vimentin. (e) BAP1 immunohistochemistry showed loss of nuclear staining in tumor cells.
Mentions: In December 2009, the above patient’s 76-year-old husband with gross hematuria and was referred to our hospital. Enhanced CT scans of the abdomen revealed an 80 mm mass in his right kidney and tumor thrombus into the inferior vena cava (Figure 1b). In January 2010, right radical nephrectomy with vena caval thrombectomy was performed without any intraoperative or postoperative complications. Histological evaluation of the tumor denoted Fuhrman nuclear grade 4 clear cell RCC with rhabdoid features and sarcomatoid change (Figure 3a, b and c). Immunohistochemically, the rhabdoid cells were positive for vimentin, whereas the tumor cell nuclei were mostly negative for BAP1 (Figure 3d and e). In January 2011, the patient complained of lower back pain and neurological disorder of the lower extremity. Magnetic resonance imaging revealed vertebral metastasis at the L1 level and compression of the spinal cord. The patient died of an unrelated cause in April 2011.Figure 3

Bottom Line: Bone metastasis occurred 12 months postoperatively, but he died of an unrelated cause 18 months after surgery.Concurrent occurrence of RCC with rhabdoid features may not to be coincidental.Although further studies are warranted, asbestos exposure may contribute to the etiology of clear cell RCC with rhabdoid features.

View Article: PubMed Central - PubMed

Affiliation: Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, North-15, West-7, Sapporo, Japan. ryu-matsumoto@amber.plala.or.jp.

ABSTRACT

Background: Renal cell carcinoma (RCC) with rhabdoid features is a rare histology and exhibits clinically aggressive behavior. We report a case of a married couple in whom RCC with rhabdoid features concurrently occurred. The rarity of this event suggests that environmental factors may contribute to the etiology of RCC with rhabdoid features.

Case presentation: A 76-year-old Japanese woman was diagnosed with a hypervascular mass in the right kidney and tumor thrombus extending into the right atrium by enhanced computed tomography (CT). She underwent radical nephrectomy and tumor thrombectomy following systemic therapy with the tyrosine kinase inhibitor sunitinib. The histological evaluation denoted clear cell RCC with rhabdoid features. The patient died of cancer 12 months postoperatively. A 76-year-old man, her husband, presented with gross hematuria 2 weeks after his wife had undergone surgery. He had a long history of asbestos exposure. An abdominal CT scan revealed a hypervascular mass in the right kidney and tumor thrombus extending into the inferior vena cava. He also underwent radical nephrectomy and tumor thrombectomy. The histological evaluation also showed clear cell RCC with rhabdoid features. Bone metastasis occurred 12 months postoperatively, but he died of an unrelated cause 18 months after surgery.

Conclusion: Concurrent occurrence of RCC with rhabdoid features may not to be coincidental. Although further studies are warranted, asbestos exposure may contribute to the etiology of clear cell RCC with rhabdoid features.

Show MeSH
Related in: MedlinePlus