Collecting duct carcinoma of the kidney: A case report

Abstract

Abstract. Collecting duct carcinoma (CDC) is a rare type of renal tumor, arising from the distal collecting ducts. The prognosis of this disease is extremely poor due to its rapid progression with widespread metastases. The present study reported a case of CDC involving the right renal region of a 62-year-old female patient, presented with right-flank pain that had persisted for one month. A computed tomography scan demonstrated multiple hypoattenuating quasicircular lesions, 0.5-4.3 cm in size, in the upper pole of the right kidney. Following the diagnosis of a right renal tumor, laparoscopic radical resection of the right kidney was performed. Pathological examination demonstrated that the tumor cells were arranged in a glandular or papillary pattern, and marked cytological atypia was observed. Immunohistochemical staining revealed that the tumor cells were positive for epithelial membrane antigen and cytokeratin (CK)7, while they reacted focally with vimentin. However, the tumor cells were negative for CK20, CD10, uroplakin Ⅲ and p63. Based on these findings, the patient was diagnosed with CDC. In conclusion, immunohistochemical analysis is critical in establishing an accurate diagnosis of CDC and distinguishing this tumor from other subtypes of RCC. IntroductionCollecting duct carcinoma (CDC) is a rare subtype of renal epithelial neoplasm, accounting for <2% of all the renal cell carcinoma (RCC) cases (1). This aggressive malignancy is considered to be derived from the collecting duct of the kidney and has a poor prognosis in the majority of patients (2-5) with a median survival time of only 22 months following nephrectomy (6). Despite the histological and immunohistochemical features of this disease, distinguishing CDC from pelvic urothelial carcinoma and high-grade papillary RCC is difficult, mainly due to the varying features of CDC (7). The tumor is usually identified in or proximal to the renal pelvis and appears gray or white without extensive necrosis or hemorrhage (8).Various treatments have been reported in the literature, including immunotherapy, radiation therapy, chemotherapy (5,9) and radical excision (3). In order to improve the understanding on the biological behavior of CDC, the present study reported the case of a 62-year-old female patient with typical pathological features of CDC. In addition, the clinical, pathological and immunohistochemical aspects of the disease were reviewed. Written informed consent was obtained from the patient. Case reportIn August 2013, a 62-year-old female was admitted to the First Hospital of Jilin University (Changchun, China) for evaluation of right-flank pain that had persisted for one month. The patient did not experience gross hematuria or dysuria. A physical examination was unremarkable, with the exception of mild percussion pain in the right kidney area. Blood examinations revealed an elevated erythrocyte sedimentation rate [41 ml/h; normal range, 4-30 ml/h (10)]. An abdominal ultrasonography scan demonstrated a solid, hypoechoic and relatively well-demar...

Bellini duct carcinoma of the kidney masquerading as an iliac bone tumour in an adult Nigerian

“…BDC of the kidney also known as collecting duct carcinoma of the Kidney is a rare type of RCC accounting for less that 3% of all cases of RCC and has a tendency for early metastasis and high mortality [ 2 , 3 ]. Due to these peculiarities, BDC was recognised as a separate entity by the 1998 World Health Organisation (WHO) classification [ 11 ].…”

“…Renal Cell Carcinoma (RCC) has also been called the "Internist's tumour" due to the myriad of ways it may present [ 1 ]. Bellini duct carcinoma (BDC) is a rare type of RCC accounting for less than 3% of Renal Carcinomas [ 2 , 3 ]. In Nigeria, BDC has been reported as a slightly higher fraction of RCC (4%)by Tijani et al [ 4 ].…”

Collecting Duct Carcinoma of the Native Kidney in a Renal Transplant Recipient

“…Targeted therapy, such as sunitinib, sorafenib, temsirolimus, and everolimus, has also been used with moderate success [ 20 – 22 ]. However, due to high rates of metastasis and local recurrence, nephrectomy and chemotherapy have not been found to effectively control aggressive forms of this disease [ 23 ]. About 2/3 of patients with CDC die within two years of its detection [ 14 ].…”

“…Despite its typically aggressive behavior, cases without direct invasion or metastases have been described. In a case report by Hu et al, an early diagnosis of CDC was made after a presentation of right flank pain [ 23 ]. The tumor was locally resected, with no recurrence after ten months, suggesting that CDC may be very manageable if detected in an early stage.…”

Collecting Duct Carcinoma: A Rare Entity

“…No 1 JANUARY 2020 et al, 2017) Most CDC tumor cells express PAX8, High Molecular Weight Cytokeratin, sometimes also CK7, and strongly positive for epithelial membrane antigen (EMA), focal reactive with vimentin, but they do not express CK20, CD117, CD10, GATA3 and p63 on immunohistochemistry staining (Hu et al, 2015;López et al, 2015;Zheng et al, 2017).…”