Limits...
Pediatric Papillary Renal Cell Carcinoma in a Horseshoe Kidney: A Case Report with Review of the Literature.

Loya-Solis A, Alemán-Meza L, Canales-Martínez LC, Franco-Márquez R, Rincón-Bahena AA, Nuñez-Barragán KM, Garza-Guajardo R, Ponce-Camacho MA - Case Rep Pathol (2015)

Bottom Line: Microscopically the tumor was composed of papillae covered with cells with abundant eosinophilic cytoplasm and high-grade nuclei with prominent nucleoli.Immunohistochemistry was performed; EMA, Vimentin, and AMACR were strongly positive while CK7, CD10, RCC antigen, TFE3, HMB-45, and WT-1 were negative.Currently, 10 months after the surgical procedure, the patient remains clinically and radiologically disease-free.

View Article: PubMed Central - PubMed

Affiliation: Pathology Department, Spanish Hospital of Mexico, Ejercito Nacional 613, 11560 Mexico City, DF, Mexico.

ABSTRACT
Renal cell carcinoma is the most common malignancy of the kidney in adults. In children, however, it only accounts for an estimated 1.8 to 6.3% of all pediatric malignant renal tumors. Papillary renal cell carcinoma is the second most common type of renal cell carcinoma in children. We present the case of a 12-year-old boy with a 2-month history of abdominal pain, unexplained weight loss, and gross hematuria. Computed tomography revealed a horseshoe kidney and a well-defined mass of 4 cm arising from the lower pole of the right kidney. Microscopically the tumor was composed of papillae covered with cells with abundant eosinophilic cytoplasm and high-grade nuclei with prominent nucleoli. Immunohistochemistry was performed; EMA, Vimentin, and AMACR were strongly positive while CK7, CD10, RCC antigen, TFE3, HMB-45, and WT-1 were negative. Currently, 10 months after the surgical procedure, the patient remains clinically and radiologically disease-free.

No MeSH data available.


Related in: MedlinePlus

Abdominal computed tomography revealed an ill-defined tumor arising from the lower pole of the right kidney.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4537719&req=5

fig1: Abdominal computed tomography revealed an ill-defined tumor arising from the lower pole of the right kidney.

Mentions: A 12-year-old boy presented with a 2-month history of abdominal pain, unexplained weight loss, and gross hematuria. Physical examination revealed no abnormalities. Urine examination confirmed gross hematuria and urine culture was sterile. Laboratory blood analyses were within normal limits and urinary excretion of catecholamines was also within the normal range. Upper abdominal computed tomography revealed a horseshoe kidney and a well-defined mass of 4 cm arising from the lower pole of the right kidney (Figure 1). Right nephroureterectomy with division of the isthmus of the horseshoe kidney was performed. The cut surface of the excised specimen showed a solid, circumscribed, heterogeneous tumor (size 4.3 × 3.5 cm), with solid areas alternating with cystic and hemorrhagic areas with widely clear margins (Figure 2). Histopathological examination revealed a tumor surrounded by a pseudocapsule, composed of papillae covered with cells with abundant eosinophilic cytoplasm and high-grade nuclei with prominent nucleoli (Figure 3). Immunohistochemistry was performed using cytokeratin 7 (CK7), epithelial membrane antigen (EMA), Vimentin, CD10, RCC antigen, TFE3, HMB-45, WT-1, and alpha-methylacyl coenzyme-A racemase (AMACR). EMA, Vimentin, and AMACR were strongly positive (Figure 4). CK7, CD10, RCC antigen, TFE3, HMB-45, and WT-1 were negative. In view of these histopathological and immunohistochemistry findings a type 2 PRCC was diagnosed. Currently, 10 months after the surgical procedure, the patient remains clinically and radiologically disease-free.


Pediatric Papillary Renal Cell Carcinoma in a Horseshoe Kidney: A Case Report with Review of the Literature.

Loya-Solis A, Alemán-Meza L, Canales-Martínez LC, Franco-Márquez R, Rincón-Bahena AA, Nuñez-Barragán KM, Garza-Guajardo R, Ponce-Camacho MA - Case Rep Pathol (2015)

Abdominal computed tomography revealed an ill-defined tumor arising from the lower pole of the right kidney.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4537719&req=5

fig1: Abdominal computed tomography revealed an ill-defined tumor arising from the lower pole of the right kidney.
Mentions: A 12-year-old boy presented with a 2-month history of abdominal pain, unexplained weight loss, and gross hematuria. Physical examination revealed no abnormalities. Urine examination confirmed gross hematuria and urine culture was sterile. Laboratory blood analyses were within normal limits and urinary excretion of catecholamines was also within the normal range. Upper abdominal computed tomography revealed a horseshoe kidney and a well-defined mass of 4 cm arising from the lower pole of the right kidney (Figure 1). Right nephroureterectomy with division of the isthmus of the horseshoe kidney was performed. The cut surface of the excised specimen showed a solid, circumscribed, heterogeneous tumor (size 4.3 × 3.5 cm), with solid areas alternating with cystic and hemorrhagic areas with widely clear margins (Figure 2). Histopathological examination revealed a tumor surrounded by a pseudocapsule, composed of papillae covered with cells with abundant eosinophilic cytoplasm and high-grade nuclei with prominent nucleoli (Figure 3). Immunohistochemistry was performed using cytokeratin 7 (CK7), epithelial membrane antigen (EMA), Vimentin, CD10, RCC antigen, TFE3, HMB-45, WT-1, and alpha-methylacyl coenzyme-A racemase (AMACR). EMA, Vimentin, and AMACR were strongly positive (Figure 4). CK7, CD10, RCC antigen, TFE3, HMB-45, and WT-1 were negative. In view of these histopathological and immunohistochemistry findings a type 2 PRCC was diagnosed. Currently, 10 months after the surgical procedure, the patient remains clinically and radiologically disease-free.

Bottom Line: Microscopically the tumor was composed of papillae covered with cells with abundant eosinophilic cytoplasm and high-grade nuclei with prominent nucleoli.Immunohistochemistry was performed; EMA, Vimentin, and AMACR were strongly positive while CK7, CD10, RCC antigen, TFE3, HMB-45, and WT-1 were negative.Currently, 10 months after the surgical procedure, the patient remains clinically and radiologically disease-free.

View Article: PubMed Central - PubMed

Affiliation: Pathology Department, Spanish Hospital of Mexico, Ejercito Nacional 613, 11560 Mexico City, DF, Mexico.

ABSTRACT
Renal cell carcinoma is the most common malignancy of the kidney in adults. In children, however, it only accounts for an estimated 1.8 to 6.3% of all pediatric malignant renal tumors. Papillary renal cell carcinoma is the second most common type of renal cell carcinoma in children. We present the case of a 12-year-old boy with a 2-month history of abdominal pain, unexplained weight loss, and gross hematuria. Computed tomography revealed a horseshoe kidney and a well-defined mass of 4 cm arising from the lower pole of the right kidney. Microscopically the tumor was composed of papillae covered with cells with abundant eosinophilic cytoplasm and high-grade nuclei with prominent nucleoli. Immunohistochemistry was performed; EMA, Vimentin, and AMACR were strongly positive while CK7, CD10, RCC antigen, TFE3, HMB-45, and WT-1 were negative. Currently, 10 months after the surgical procedure, the patient remains clinically and radiologically disease-free.

No MeSH data available.


Related in: MedlinePlus