Ipsilateral synchronous clear and papillary renal cell carcinoma: A case report and review of the literature

Alhusban, Muna; Alhamss, Sohaib; Alzumaili, Bayan; Al-Daghmin, Ali

doi:10.1016/j.eucr.2017.11.020

Cited by 14 publications

(12 citation statements)

References 23 publications

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“…Awareness of the coexistence of multiple synchronous tumors of different pathologic neoplasms in the same kidney is important for managing such cases, and nephron-sparing surgery or active surveillance may be warranted for some renal masses [22]. The fact that the pathological concordance rate is as low as 67.3% and the grade concordance rate is 62.5% [23] suggests that if a biopsy is indicated preoperatively, each nodule should be biopsied for diagnosis [8]. Different tumors will have different prognoses and degrees of aggressiveness.…”

Section: Discussionmentioning

confidence: 99%

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Unilateral synchronous papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma: a case report with KRAS and PIK3CA mutations

et al. 2020

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Background The presence of histologically different neoplasms in the same organ is rare in pathologic practice. We report the first case of synchronous clear cell renal cell carcinoma (clear cell RCC) and papillary renal neoplasm with reverse polarity (PRNRP) with comprehensive immunohistochemical and molecular characterization using next-generation sequencing (NGS). Case presentation A 61-year-old man was incidentally found to have a left renal mass on imaging studies performed for workup of left back pain and urine color change for 1 week. A laparoscopic left radical nephrectomy was performed. Gross examination showed lobulated masses measuring 5.6 × 4.0 × 3.3 cm in the upper to mid pole and 1.1 × 1.0 × 1.0 cm in the lower pole. Microscopic findings revealed these to be two different separate masses of clear cell renal cell carcinoma and papillary renal neoplasm with reverse polarity. NGS analyses revealed KRAS gene mutation (c.35G > T/p.G12V in exon 2) in the papillary renal neoplasm with reverse polarity, with PIK3CA gene mutation restricted to the clear cell renal cell carcinoma (c.1624G > A/p.E542K in exon 10). Conclusions We report here an extraordinarily rare case of synchronous renal tumors of papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma. We identified simultaneous KRAS and PIK3CA mutations in two different renal masses in the same kidney for the first time. New pathologic assessment with comparative molecular analysis of mutational profiles may be helpful for tumor studies.

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Section: Discussionmentioning

confidence: 99%

“…Although multiple synchronous renal tumors are rare, the incidence of sporadic multifocal renal tumors at the time of diagnosis as reported in the literature is 4–20% [ 8 – 10 ]. This implies that observing multiple tumors in the kidney is relatively common.…”

Section: Discussionmentioning

confidence: 99%

Unilateral synchronous papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma: a case report with KRAS and PIK3CA mutations

et al. 2020

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“…Awareness of the coexistence of multiple synchronous tumors of different pathologic neoplasms in the same kidney is important for managing such cases, and nephron-sparing surgery or active surveillance may be warranted for some renal masses [17]. The fact that the pathological concordance rate is as low as 67.3% and the grade concordance rate is 62.5% [18] suggests that if a biopsy is indicated preoperatively, each nodule should be biopsied for diagnosis [19]. Different tumors will have different prognoses and degrees of aggressiveness.…”

Section: Discussionmentioning

confidence: 99%

Unilateral synchronous papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma: a case report with KRAS and PIK3CA mutations

Lee

Shin

Park

et al. 2020

Preprint

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BackgroundThe presence of histologically different neoplasms in the same organ is rare in pathologic practice. We report multiple synchronous masses of clear cell renal cell carcinoma and papillary renal neoplasm with reverse polarity in the same kidney. Herein, we present the first well-explained case with immunohistochemical findings with next-generation sequencing (NGS) analysis. Case presentationA 61-year-old man was incidentally found to have a left renal mass on imaging studies performed for workup of left back pain and urine color change for one week. A laparoscopic left radical nephrectomy was performed. Gross examination showed lobulated masses in the upper to mid pole measuring 5.6 × 4.0 × 3.3 cm and 1.1 × 1.0 × 1.0 cm in the lower pole. Microscopic findings revealed these to be two different separate masses of clear cell renal cell carcinoma and papillary renal neoplasm with reverse polarity. NGS analyses revealed KRAS gene mutation (c.35G>T/p.G12V in exon 2) in the papillary renal neoplasm with reverse polarity, with an additional PIK3CA gene mutation restricted to the clear cell renal cell carcinoma (c.1624G>A/p.E542K in exon 10).ConclusionsWe report here an extraordinarily rare case of a patient diagnosed with multiple synchronous renal tumors of papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma. We identified simultaneous KRAS and PIK3CA mutations in two different renal masses in the same kidney for the first time. New pathologic assessment with comparative molecular analysis of mutational profiles may be helpful for tumor studies.

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“…3 Alhusban et al conducted a literature review in 2017 that found 47 cases of ipsilateral synchronous ccRCC and pRCC, of which their synchronous presence represent around 13% to 14% of multifocal RCCs. 4 Thus, although a wide range of incidence of multifocality has been reported in the literature, synchronous ccRCC and pRCC remain a rare finding.…”

Section: Discussionmentioning

confidence: 99%

Radiologically missed synchronous ipsilateral renal tumours with varying histology

Heidar

Labban

Mansour

et al. 2019

Journal of Clinical Urology

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Ipsilateral synchronous clear and papillary renal cell carcinoma: A case report and review of the literature

Cited by 14 publications

References 23 publications

Unilateral synchronous papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma: a case report with KRAS and PIK3CA mutations

Unilateral synchronous papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma: a case report with KRAS and PIK3CA mutations

Unilateral synchronous papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma: a case report with KRAS and PIK3CA mutations

Radiologically missed synchronous ipsilateral renal tumours with varying histology

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