Pathological heterogeneity in sporadic synchronous renal tumors: Is the histological concordance predictable?

Beaugerie, A.; Audenet, François; Verkarre, Virginie; Delavaud, Christophe; Guilchet, T. Le; Hurel, S.; Aubert, Nicolas; Corréas, Jean-Michel; Fontaine, Éric; Richard, Stéphane; Méjean, A.; Timsit, Marc‐Olivier

doi:10.1016/j.urolonc.2017.09.002

Cited by 9 publications

(10 citation statements)

References 30 publications

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“…Papillary and clear cell RCCs were the most frequent types of multiple renal masses. Two reports of large numbers of patients concluded that 5-6% of multiple ipsilateral renal tumors develop a contralateral metachronous recurrence and this risk is 5 times that of patients with a sporadic single tumor [18,20]. We suggest that multiple ipsilateral synchronous RCCs of different histologic subtypes need to be followed closely and operations for each mass are necessary.…”

Section: Discussionmentioning

confidence: 91%

“…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%

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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

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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Section: Discussionmentioning

confidence: 91%

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

View full text Add to dashboard Cite

show abstract

“…While ve cases involved multiple clear cell RCCs, one presented papillary and clear cell RCCs, whereas the other had papillary RCC with metanephric adenoma. Two reports of large numbers of patients concluded that 5-6% of multiple ipsilateral renal tumors develop a contralateral metachronous recurrence and this risk is 5 times that of patients with a sporadic single tumor [23,24]. We suggest that multiple ipsilateral synchronous RCCs of different histologic subtypes need to be followed closely and operations for each mass are necessary.…”

Section: Discussionmentioning

confidence: 91%

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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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 one 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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“…Awareness of the coexistence of multiple synchronous tumors of different histology within the same kidney is important in managing such cases, especially when planning for nephron-sparing surgery (NSS) and active surveillance for some renal masses. 11 Knowing the fact that the pathological concordance rate can be as low as 67.3% and the grade concordance rate even lower, 62.5% 17 implies that if biopsy is indicated preoperatively, or in intraoperative setting for frozen section biopsy, each of the multiple nodules should be biopsied; because different tumors will carry different prognosis rates and will vary in aggressiveness. 16 Using needle biopsy was not successful in determining the histological subtype of renal masses with much reliability.…”

Section: Discussionmentioning

confidence: 99%

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

Alhusban

Alhamss

Alzumaili

et al. 2018

Urology Case Reports

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Clear cell renal cell carcinoma and papillary renal cell carcinoma are the most common types of renal tumors. However, coexistence of both tumors in the same kidney is a rare condition.We report a 56-year old male who was found to have ipsilateral synchronous clear cell and papillary renal cell carcinoma in the left kidney. Review of related literature is provided to estimate the prevalence of similar cases.

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Pathological heterogeneity in sporadic synchronous renal tumors: Is the histological concordance predictable?

Cited by 9 publications

References 30 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

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

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