A Case Report of Papillary Renal Cell Carcinoma Seeding along a Percutaneous Biopsy Tract

Abstract

We report a rare case of a papillary renal cell carcinoma seeding along a percutaneous biopsy tract detected at the time of partial nephrectomy in a 51-year-old man with a 3.5 cm renal mass discovered on computed tomography scan (CT scan). Although renal percutaneous biopsy is now considered as an accurate and safe technique to provide valuable diagnostic information for indeterminate renal lesions, some inherent risks have been reported to associate with this procedure. One of the risks is tumor needle tract seeding, which is a very rare complication of renal percutaneous biopsy. Our well-documented case report could provide some useful information to evaluate the prognosis of patients with tumor seeding along a percutaneous biopsy tract.

Needle tract seeding in renal tumor biopsies: experience from a single institution

“…We did not observe biopsy needle tract tumor seeding in CCRCC in our case series, while rare cases of tumor seeding in CCRCC were published previously [8,12]. Biopsy tract seeding was not observed in CCPRCC and ChRCC either, but the sample sizes for these two subtypes were small.…”

“…To date, there are a total of 25 reported cases on tumor seeding along the percutaneous renal mass biopsy tract, from several case reports and one case series [8,[11][12][13][14][15][16]. Of these, PRCC (15 cases) was the most commonly encountered pathologic subtype.…”

“…Complications other than hematoma are rare. These include tumor seeding along the needle tract, arteriovenous fistula formation, infection and pneumothorax [7][8][9]. In particular, tumor seeding along the biopsy needle tract is always a safety issue to consider in biopsy procedures or fine needle aspiration of mass lesions in various tissues, as it poses potential risk of iatrogenic local tumor spread by seeded malignant cells and possible subsequent cancer recurrence or dissemination [1].…”

“…Historically, the rate of needle tract tumor seeding in renal biopsy was estimated to be as low as 0.01 % by Smith in 1991, and Herts and Baker in 1995 [9,10]. To date, only a handful of case reports and a small case series have been published [8,[11][12][13][14][15][16]. However, the frequency and clinical significance of biopsy-associated tumor seeding remains largely controversial due at least in part to lack of systemic review, histological analysis and follow up data in early studies [9,10,17].…”

From kidney injury to kidney cancer

“…The link between these 2 conditions is represented by the metabolic overload of the cells of proximal tubule in remnant nephrons experiencing a drastically increased single-nephron hyperfiltration (and tubular hyperreabsorption). 47 This drives chronic cortical damage and CKD in patients with obesity and diabetes, with possible subsequent development of ccRCC, which typically originates from cells of the cortical proximal tubule (S1/S2 segment) 47 (Figure 1 25,[44][45][46][48][49][50][51][52][53][54][55][56][57] ).…”