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Liu T, Yao Y, Geng C, Guan F, Zhang G. Sarcomatoid renal pelvis carcinoma: Experience of treatment at a single-institution. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108251. [PMID: 38492258 DOI: 10.1016/j.ejso.2024.108251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES Sarcomatoid renal pelvis carcinoma (SRPC) is a rare variant of RPC. We aimed to summarize the clinicopathological features and prognostic factors of SRPC. METHODS In this retrospective study, we collected data from 24 patients with SRPC who were treated at the Department of Urology, Affiliated Hospital of Qingdao University between 2008 and 2021. The clinicopathological features of the patients were obtained from their medical records to evaluate the diagnosis, prognostic factors, and response to systemic therapy. RESULTS Immunohistochemical staining revealed that cytokeratin was expressed in 19 patients with SRPC, while vimentin was expressed in all patients. Computer tomography showed these tumors as low-density (n = 12) or mixed-density masses, with or without necrotic areas (n = 12). All patients showed different degrees of enhancement on computed tomography. Lymph node metastasis was present in 6 patients and distant metastasis in 5. The median survival of all patients was 28 months. Patients without metastasis had a median survival of 46 months compared with 18 months in those with metastasis (P < 0.05). Necrosis had no significant influence on prognosis (P > 0.05). The median survival of patients with and without hydronephrosis was 18 and 104 months (P < 0.05). Among patients without metastasis, those without hydronephrosis survived longer than those with hydronephrosis (104 vs 18 months, P < 0.05), and necrosis had no effect on prognosis. In patients with metastasis, necrosis and hydronephrosis had no effect on prognosis (P > 0.05). CONCLUSION The prognosis of SRPC is poor, and the clinical stage, particularly the presence of distant metastasis, has a significant impact on prognosis.
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Affiliation(s)
- Tian Liu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu Yao
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chaoqun Geng
- Department of Pharmaceutical Analysis, School of Pharmacy, Qingdao University, Qingdao, China
| | - Fengju Guan
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guiming Zhang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China.
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2
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Guan HY, Wang J, Wang JX, Chen QH, Lu J, He L. Renal pelvis sarcomatoid carcinoma with renal vein tumor thrombus: A case report and literature review. World J Clin Cases 2023; 11:7690-7698. [DOI: 10.12998/wjcc.v11.i31.7690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/06/2023] [Accepted: 10/26/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Renal pelvis sarcomatoid carcinoma (RPSC) is a rare and aggressive malignancy whose diagnosis is difficult because radiological imaging results can lead to misclassification as a more common type of renal tumor. In addition, clinical management of patients with RPSC is difficult because of the limited efficacy of available treatments. In this study, we present a comprehensive description of a patient who presented with RPSC and a simultaneous renal vein tumor thrombus.
CASE SUMMARY During April, 2020, a 64-year-old female presented with an isolated episode of hematuria accompanied by abdominal pain. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a lesion in the right renal pelvis. We therefore performed a radical nephrectomy of the right kidney. The subsequent histopathological and immunological results verified the diagnosis of RPSC. Despite administration of 6 cycles of a gemcitabine-cisplatin regimen, the patient's condition progressively deteriorated, and she died about 15 mo after the nephrectomy.
CONCLUSION We performed a comprehensive analysis of a patient with RPSC that included CT, MRI, immunohistochemistry, and genetic testing. The insights from our detailed analysis of this patient and our concomitant review of the literature may assist clinicians in their diagnosis and treatment of RPSC.
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Affiliation(s)
- Huai-Yong Guan
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
| | - Jin Wang
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
| | - Ji-Xue Wang
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
| | - Qi-Hui Chen
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
| | - Ji Lu
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
| | - Liang He
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
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3
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Chu Y, Ning H, Yin K, Chen T, Wu H, Wang D, Liu F, Zhao Z, Lv J. Case report: Sarcomatoid urothelial carcinoma of the renal pelvis masquerading as a renal abscess. Front Oncol 2023; 13:1055229. [PMID: 36756151 PMCID: PMC9899929 DOI: 10.3389/fonc.2023.1055229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/05/2023] [Indexed: 01/24/2023] Open
Abstract
Sarcomatoid urothelial carcinoma (SUC), a rare tumor of the urinary tract epithelium, exhibits a high degree of malignancy and therefore a poor prognosis. Due to the absence of specific clinical presentations and imaging findings, SUC of the renal pelvis masquerades as a renal abscess is frequently under-recognized or misdiagnosed as benign inflammatory disease, resulting in delayed or erroneous treatment. Here, we report a patient with SUC of the renal pelvis who presented with a renal abscess. Repeated anti-inflammatory treatment was ineffective. Unexpectedly, cancerous cells were detected in subsequent exfoliative cytology of nephrostomy drainage fluid. In accordance with this, radical surgery and postoperative chemotherapy were conducted. Fortunately, neither recurrence nor metastasis occurred during a one-year follow-up.
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Affiliation(s)
- Yaru Chu
- Department of Urology, Provincial Hospital Affiliated to Shandong First Medical University, Shandong First Medical University, Jinan, China
| | - Hao Ning
- Department of Urology, Provincial Hospital Affiliated to Shandong First Medical University, Shandong First Medical University, Jinan, China,Department of Urology, Shandong Provincial Hospital, Shandong University School of Medicine, Jinan, China
| | - Ke Yin
- Department of Pathology, Shandong Provincial Hospital, Shandong University School of Medicine, Jinan, China
| | - Tong Chen
- Department of Urology, Shandong Provincial Hospital, Shandong University School of Medicine, Jinan, China
| | - Haihu Wu
- Department of Urology, Provincial Hospital Affiliated to Shandong First Medical University, Shandong First Medical University, Jinan, China,Department of Urology, Shandong Provincial Hospital, Shandong University School of Medicine, Jinan, China
| | - Delin Wang
- Department of Urology, Provincial Hospital Affiliated to Shandong First Medical University, Shandong First Medical University, Jinan, China
| | - Feifan Liu
- Department of Urology, Shandong Provincial Hospital, Shandong University School of Medicine, Jinan, China
| | - Zhenlin Zhao
- Department of Urology, Provincial Hospital Affiliated to Shandong First Medical University, Shandong First Medical University, Jinan, China
| | - Jiaju Lv
- Department of Urology, Provincial Hospital Affiliated to Shandong First Medical University, Shandong First Medical University, Jinan, China,Department of Urology, Shandong Provincial Hospital, Shandong University School of Medicine, Jinan, China,*Correspondence: Jiaju Lv,
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4
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Nakano Y, Kitano H, Hieda K, Babasaki T, Takemoto K, Hayashi T, Kido A, Taniyama D, Sentani K, Hinata N. Sarcomatoid variant of urothelial carcinoma of renal pelvis with direct invasion of the pancreas and descending colon. IJU Case Rep 2022; 5:350-353. [PMID: 36090945 PMCID: PMC9436688 DOI: 10.1002/iju5.12479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/13/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Case presentation Conclusion
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Affiliation(s)
- Yoshinori Nakano
- Department of Urology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Hiroyuki Kitano
- Department of Urology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Keisuke Hieda
- Department of Urology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Takashi Babasaki
- Department of Urology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Kenshiro Takemoto
- Department of Urology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Tetsutaro Hayashi
- Department of Urology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Aya Kido
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Daiki Taniyama
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Kazuhiro Sentani
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Nobuyuki Hinata
- Department of Urology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
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De Lorenzis E, Albo G, Longo F, Bebi C, Boeri L, Montanari E. Current Knowledge on Genomic Profiling of Upper Tract Urothelial Carcinoma. Genes (Basel) 2021; 12:genes12030333. [PMID: 33668859 PMCID: PMC7996334 DOI: 10.3390/genes12030333] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
Recent research in next-generation sequencing characterized the genomic landscape of urothelial cancer. However, the majority of the studies focused on bladder cancer (BC). Upper urinary tract urothelial carcinomas (UTUC) and BC share some histological characteristics, but, considering the differences in terms of embryologic precursors, epidemiology, genetics, medical and surgical management and response to therapy, UTUC and BC should be considered as two distinct diseases. Our objective is to analyze through a literature search the latest updates and the current knowledge about the genomics of UTUC. We also evaluate genetic differences between BC and UTUC and the potential implications for systemic therapy. Molecular subtyping and variant histology and their correlation with response to chemotherapy were also explored. In summary, the most frequent genomic variations in UTUC included FGFR3, chromatin remodeling genes, TP53/MDM2 and other tumor suppressors/oncogenes. The genomics of UTUC, integrated with clinical data, could drive the selection of patients who could benefit from targeted therapy or off-label treatment. Routine implementation of tumor genomic characterization in UTUC patients should therefore be contemplated and evaluated prospectively.
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Affiliation(s)
- Elisa De Lorenzis
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-02-55034546; Fax: +39-02-50320584
| | - Giancarlo Albo
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Fabrizio Longo
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
| | - Carolina Bebi
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
- University of Milan, 20122 Milan, Italy
| | - Luca Boeri
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
- University of Milan, 20122 Milan, Italy
| | - Emanuele Montanari
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
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Barton GJ, Tan WP, Inman BA. The nephroureterectomy: a review of technique and current controversies. Transl Androl Urol 2020; 9:3168-3190. [PMID: 33457289 PMCID: PMC7807352 DOI: 10.21037/tau.2019.12.07] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The nephroureterectomy (NU) is the standard of care for invasive upper tract urothelial carcinoma (UTUC) and has been around for well over one hundred years. Since then new operative techniques have emerged, new technologies have developed, and the surgery continues to evolve and grow. In this article, we review the various surgical techniques, as well as present the literature surrounding current areas of debate surrounding the NU, including the lymphatic drainage of the upper urinary tract, management of UTUC involvement with the adrenals and caval thrombi, surgical management of the distal ureter, the use of intravesical chemotherapy as well as perioperative systemic chemotherapy, as well as various outcome measures. Although much has been studied about the NU, there still is a dearth of level 1 evidence and the field would benefit from further studies.
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Affiliation(s)
- Gregory J Barton
- Division of Urology, Duke University Medical Center, Durham, NC, USA
| | - Wei Phin Tan
- Division of Urology, Duke University Medical Center, Durham, NC, USA
| | - Brant A Inman
- Division of Urology, Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
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7
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Mantica G, Benelli A, Ackermann H, Nxumalo Z, Solaiman A, Dotta F, van der Merwe A, Terrone C. Clinical and histopathological features of carcinosarcoma of the renal pelvis: a systematic review of a rare tumor. MINERVA UROL NEFROL 2019; 71:121-126. [DOI: 10.23736/s0393-2249.18.03192-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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8
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Wang Y, Liu H, Wang P. Primary sarcomatoid urothelial carcinoma of the ureter: a case report and review of the literature. World J Surg Oncol 2018; 16:77. [PMID: 29653574 PMCID: PMC5899376 DOI: 10.1186/s12957-018-1383-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 04/05/2018] [Indexed: 11/26/2022] Open
Abstract
Background Sarcomatoid urothelial carcinoma is a very dangerous malignant tumour derived from the epithelium. Primary sarcomatoid carcinoma of the ureter is extremely rare in clinical practice. The prognosis of this kind of disease is really poor, and there is still not a diagnosis standard in the world. Case presentation An 82-year-old female patient who had intermittent waist pain without any other symptoms, had diagnosed as urothelial cancer on computerised tomography urography. Considering the patient’s age and quality of life, we made a preserving kidneys resection of the local tumour. The tumour was composed of sarcomatous and carcinomatous elements, and immunohistochemical examination showed that tumour cells were positive for cytokeratin, epithelial membrane antigen, vimentin, and GATA3 markers. There were no complications after 1-hour surgery. After 3 months, there was no signs of recurrence and metastasis. Conclusion This case was a patient with sacomatoid urothelial carcinoma. Through a transurethral resection with laser, the patient recovered well, and there was no sign of any recurrence of the tumour after 3 months. With the development of technology and science, more and more cancerous patients’ living quality and survival rate were improved. Maybe it is essential for urologists and scientists to entirely understand the characteristics of the sarcomatoid urothelial carcinoma and make a better clinical guideline.
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Affiliation(s)
- Yixiang Wang
- Department of Urology, The Fourth Hospital Affiliated to China Medical University, Chongshan East street, Shenyang, Liaoning, 110032, People's Republic of China
| | - Hanchao Liu
- Department of Urology, The Fourth Hospital Affiliated to China Medical University, Chongshan East street, Shenyang, Liaoning, 110032, People's Republic of China
| | - Ping Wang
- Department of Urology, The Fourth Hospital Affiliated to China Medical University, Chongshan East street, Shenyang, Liaoning, 110032, People's Republic of China.
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9
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Rashid S, Akhtar M. Sarcomatoid Variant of Urothelial Carcinoma of the Renal Pelvis with Inferior Vena Cava Tumour Thrombus: A Case Report and Literature Review. Case Rep Pathol 2018; 2018:1837510. [PMID: 29581908 PMCID: PMC5822868 DOI: 10.1155/2018/1837510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/20/2017] [Indexed: 11/24/2022] Open
Abstract
Sarcomatoid variant of urothelial carcinoma (SVUC) of the renal pelvis is a rare entity. To the best of our knowledge, around 25 cases of this neoplasm have been reported in the literature to date, most of which were of high stage. The inferior vena cava tumour thrombus, which is a hallmark of renal cell carcinoma (RCC), may rarely be found in urothelial carcinoma of renal pelvis. In this report, a case of SVUC associated with tumour extension to inferior vena cava is documented. This association has been encountered in only one previously reported case. The possibility of urothelial carcinoma of the renal pelvis should therefore be included in the differential diagnosis of tumour thrombus of the inferior vena cava.
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Affiliation(s)
- Sameera Rashid
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Akhtar
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
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Cuadra-Urteaga JL, Font A, Tapia G, Areal J, Taron M. Carcinosarcoma of the upper urinary tract with an aggressive angiosarcoma component. Cancer Biol Ther 2016; 17:233-6. [PMID: 26891233 DOI: 10.1080/15384047.2016.1139237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Carcinosarcomas (CS) are biphasic tumors with malignant epithelial and mesenchymal elements. The sarcomatoid elements of CS can include chondrosarcoma, malignant fibrous histiocytoma, osteosarcoma, leiomyosarcoma, fibrosarcoma, or liposarcoma. CS of the upper urinary tract are extremely rare but are associated with a poor prognosis. We report a case of a 44-year-old man with a localized right renal pelvis mass treated with a right nephroureterectomy. The pathological examination showed a high-grade urothelial carcinoma of the renal pelvis, stage III (pT3aNxM0). A few days later, he developed lower back pain, hematuria, cough with hemoptoic sputum and progressive dyspnea. Radiological explorations showed multiple bilateral lung nodules and a retroperitoneal mass. A CT-guided biopsy of the retroperitoneal mass revealed a high-grade angiosarcoma. A review of the nephrectomy specimen showed a microscopic focus of angiosarcoma in the urothelial carcinoma. Therefore, the initial diagnosis was changed to CS of the renal pelvis with an angiosarcoma component. The patient developed progressive respiratory failure and died 8 weeks after surgery. An autopsy revealed a large retroperitoneal mass with metastatic nodules to the abdominal wall, diaphragm, small intestine, liver, spleen, and lung. All lesions were angiosarcoma, with no evidence of urothelial carcinoma. This is the first case reported of a patient with CS of the upper urinary tract with an angiosarcoma component with a very aggressive course that caused the immediate appearance of multiple angiosarcoma metastases. We also describe the clinical and molecular characteristics of CS, which will help to contribute to a better understanding of this type of tumor.
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Affiliation(s)
- José Luis Cuadra-Urteaga
- a Medical Oncology Service, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona
| | - Albert Font
- a Medical Oncology Service, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona
| | - Gustavo Tapia
- b Pathology Department , Hospital Universitari Germans Trias i Pujol , Ctra. de Canyet, s/n. 08916 BADALONA ( BARCELONA )
| | - Juan Areal
- c Urology Department , Hospital Universitari Germans Trias i Pujol , Ctra. de Canyet, s/n. 08916 BADALONA ( BARCELONA )
| | - Miquel Taron
- d Molecular Biology Laboratory, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol
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Wu J, Wang X, Lin C, Yu S, Cai L, Gao Z. Carcinosarcoma of native renal pelvis in recipient after a renal transplant: a case report. World J Surg Oncol 2014; 12:407. [PMID: 25551692 PMCID: PMC4320576 DOI: 10.1186/1477-7819-12-407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 12/03/2014] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Carcinosarcoma is a malignancy that rarely occurs in the renal pelvis. MATERIALS AND METHODS We present a case of histologically proven, native renal pelvis carcinosarcoma in a 65-year-old woman who had accepted a renal transplant. We performed a laparoscopic ureterectomy, combined with lymph node dissection and immunosuppression with sirolimus (SRL), which was alternated with the conventional immunosuppressant--cyclosporine. RESULTS This patient was still alive 34 months after renal transplantation. CONCLUSIONS Operation is still the best choice, and the SRL may be beneficial for preventing the progression of a tumor.
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Affiliation(s)
| | | | | | | | - Li Cai
- Department of Urology, Yantai Yuhuangding Hospital, No,20 East Yuhuangding Road, Yantai, Shandong Province 264000, China.
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12
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Liu S, Zeng F, Qi L, Jiang S, Tan P, Zu X, Xie Y, Han W. Malignant priapism secondary to isolated penile metastasis from a renal pelvic carcinoma. Can Urol Assoc J 2014; 8:E558-60. [PMID: 25210564 DOI: 10.5489/cuaj.1695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We report a case of isolated penile metastasis from renal pelvic carcinoma in a 69-year-old man with malignant priapism. The patient had radical resection of the renal pelvic carcinoma 2 months earlier with urothelial carcinoma (UC) and sarcomatoid differentiation histology. Physical examination showed no visible skin lesions, but a palpable hard nodule was present over the penile shaft. The imaging studies did not reveal other metastases. Cavernous-Glans shunt and nodule resection were performed, and histological examination showed metastasis UC with sarcomatoid differentiation. To our knowledge, we describe the first case of malignant priapism due to isolated penile metastasis of renal pelvic carcinoma.
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Affiliation(s)
- Sulai Liu
- Department of Urology, Xiangya Hospital, The Central South University, Changsha China; ; Department of Urology, The Affiliated Tumor Hospital of Xiangya Medical School, The Central South University, Changsha, China
| | - Fuhua Zeng
- Department of Urology, The Affiliated Tumor Hospital of Xiangya Medical School, The Central South University, Changsha, China
| | - Lin Qi
- Department of Urology, Xiangya Hospital, The Central South University, Changsha China
| | - Shusuan Jiang
- Department of Urology, The Affiliated Tumor Hospital of Xiangya Medical School, The Central South University, Changsha, China; ; Department of Urology, The first affiliated hospital of Guangxi Medical University, Nanning, China
| | - Pingping Tan
- Department of Pathology, The Affiliated Tumor Hospital of Xiangya Medical School, The Central South University, Changsha, China
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, The Central South University, Changsha China
| | - Yu Xie
- Department of Urology, The Affiliated Tumor Hospital of Xiangya Medical School, The Central South University, Changsha, China
| | - Weiqing Han
- Department of Urology, The Affiliated Tumor Hospital of Xiangya Medical School, The Central South University, Changsha, China
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13
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Diaz RR, Kwon JK, Lee JY, Nahm JH, Cho KS, Ham WS, Cho NH, Choi YD. Renal pelvic urothelial carcinoma with vena caval thrombus mimicking renal cell carcinoma. Korean J Urol 2014; 55:624-7. [PMID: 25237466 PMCID: PMC4165927 DOI: 10.4111/kju.2014.55.9.624] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 11/08/2012] [Indexed: 11/18/2022] Open
Abstract
A 61-year-old man presented with a right renal mass with a vena caval thrombus on computed tomography that was consistent with renal cell carcinoma. The results of routine laboratory examinations and urinalysis were within normal limits. Preoperative planning was critical owing to the presence of the vena caval thrombus. A radical nephrectomy, vena caval thrombectomy, and regional lymphadenectomy were done. The pathologic report was consistent with a high-grade, invasive urothelial carcinoma, with sarcomatoid differentiation involving the renal vein and inferior vena cava (Stage IV, T4N0M0). Thus, this was a rare case of upper tract urothelial carcinoma. Adjuvant chemotherapy with the methotrexate, vinblastine, doxorubicin, cisplatinum regimen is scheduled. To our knowledge, this is the first report in Korea of upper tract urothelial carcinoma of the sarcomatoid type with a vena caval thrombus.
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Affiliation(s)
- Richilda Red Diaz
- Department of Urology, Urological Science Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Kyou Kwon
- Department of Urology, Urological Science Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Joo Yong Lee
- Department of Urology, Urological Science Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hae Nahm
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Kang Su Cho
- Department of Urology, Urological Science Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won Sik Ham
- Department of Urology, Urological Science Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Nam Hoon Cho
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Deuk Choi
- Department of Urology, Urological Science Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ; Clinical Trials Center for Medical Devices, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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14
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Tian X, Zhao J, Wang Y, Xing N. Sarcomatoid carcinoma of the renal pelvis: A case report. Oncol Lett 2014; 8:1208-1210. [PMID: 25120689 PMCID: PMC4114623 DOI: 10.3892/ol.2014.2240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 05/15/2014] [Indexed: 11/06/2022] Open
Abstract
Sarcomatoid carcinoma is a high-grade malignant neoplasm which exhibits morphological and/or immunohistochemical evidence of bidirectional epithelial and mesenchymal differentiation. Sarcomatoid carcinoma occurring in the upper urinary tract is rare. The present study reports a case of primary sarcomatoid carcinoma of the renal pelvis. A 49-year-old female patient was admitted to Beijing Chao-Yang Hospital for experiencing two weeks of intermittent hematuria. A computed tomography scan revealed a mass of 2 cm in diameter in the left renal pelvis. A retroperitoneoscopic nephroureterectomy combined with a bladder cuff excision was performed, and the final pathological diagnosis was sarcomatoid carcinoma of the renal pelvis. The patient did not receive systemic chemotherapy and radiotherapy. Regular follow-up was performed for 30 months, and there was no evidence of tumor local recurrence or distant metastasis.
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Affiliation(s)
- Xiquan Tian
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Jiyu Zhao
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Yue Wang
- Department of Pathology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Nianzeng Xing
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, P.R. China
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Sarcomatoid variant of urothelial carcinoma (carcinosarcoma, spindle cell carcinoma): a review of the literature. ISRN UROLOGY 2014; 2014:794563. [PMID: 24587922 PMCID: PMC3920806 DOI: 10.1155/2014/794563] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 11/09/2013] [Indexed: 01/09/2023]
Abstract
Background. Sarcomatoid variant of urothelial carcinoma (SVUC) was added to the WHO classification in 2004. Aims. To review the literature. Materials and Method. Various internet databases were used. Result. SVUCs are rare biphasic malignant neoplasms exhibiting morphologic/immunohistochemical evidence of epithelial and mesenchymal differentiation with the presence or absence of heterologous elements. Some cases of SVUC have been associated with radiation therapy and cyclophosphamide treatment. Patients' ages range from 50 to 77 years (mean age 66). Patients tend to be younger and they more commonly presented with high-grade histology and advanced stage disease, in comparison with patients who had conventional urothelial carcinoma (CUC). Results of molecular/genetic studies strongly argue for a common monoclonal cell origin of both the epithelial and mesenchymal components in SUVC. The cancer specific survival of SVUC is poor in comparison with CUC. Radical surgical excision and chemoradiation may be associated with improved prognosis; chemoradiation as an organ preserving alternative to radical excision may be associated with improved outcome. There is no consensus opinion on the best treatment modalities for SUVC. Conclusions. SVUC is rare and is associated with inferior outcome compared with CUC. A multicentre trial of various treatment options is required. Cases of SVUC should be reported.
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Chen S, Chen G, Xia D, Li J, Wang S, Shen B, Jin B. Sarcomatoid carcinoma of the renal pelvis: Experience of multiple cases over a ten-year period. Oncol Lett 2013; 6:513-516. [PMID: 24137357 PMCID: PMC3788826 DOI: 10.3892/ol.2013.1396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 05/15/2013] [Indexed: 11/06/2022] Open
Abstract
Sarcomatoid carcinoma of the renal pelvis is a rare clinical entity. To the best of our knowledge, only 14 cases of this type of neoplasm have been reported in the literature to date. In the present study, the records at The First Affiliated Hospital, Medicine School of Zhejiang University (Hangzhou, Zhejiang, China) between 2000 and 2010 were reviewed to identify patients with primary renal pelvis sarcomatoid carcinoma (RPSC). A particular emphasis was placed on the treatment, recurrence and survival outcome. Eight patients with RPSC were identified and treated with nephrectomy or nephroureterectomy. All of the patients presented with Grade 3 RPSC. According to the TNM classification system, 2 patients were in stage pT2, 5 in stage pT3 and 1 in stage pT4. Adjuvant chemotherapy was administered to four patients, and the mean follow-up period was 27.5±41.0 months. In total, 6 patients succumbed to the disease with a mean survival time of 7.7±5.3 months (range, 1-18 months), while 2 patients were free of disease at 54 and 120 months, respectively, following treatment. The mean disease-specific survival time was 27.5±41.0 months and the 1-year recurrence-free survival, 1-year survival and overall survival rates were 37.5, 37.5 and 25%, respectively. The present analysis suggests a poor prognosis for the majority of RPSC patients, most likely resulting from the advanced stage of the disease at diagnosis and a poor response to systemic therapy. To improve the survival rate of RPSC, it is therefore essential to perform an early diagnosis and early radical surgery. Intravesical instillation is not essential following surgery.
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Affiliation(s)
- Shanwen Chen
- Departments of Urology, Medical School of Zhejiang University, Hangzhou, Zhejiang 310031, P.R. China
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Paick SH, Yoon SW, Baek M, Lim SD, Lho YS, Kim HG. Sarcomatoid Urothelial Carcinoma of the Renal Pelvis with Extremely Aggressive Clinical Behavior. Korean J Urol 2009. [DOI: 10.4111/kju.2009.50.8.812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Sung Hyun Paick
- Department of Urology, Konkuk University College of Medicine, Seoul, Korea
| | | | - Minki Baek
- Department of Urology, Konkuk University College of Medicine, Seoul, Korea
| | - So Dug Lim
- Department of Pathology, Konkuk University College of Medicine, Seoul, Korea
| | - Yong Soo Lho
- Department of Urology, Konkuk University College of Medicine, Seoul, Korea
| | - Hyeong Gon Kim
- Department of Urology, Konkuk University College of Medicine, Seoul, Korea
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Neoplasms of the upper urinary tract: a review with focus on urothelial carcinoma of the pelvicalyceal system and aspects related to its diagnosis and reporting. Adv Anat Pathol 2008; 15:127-39. [PMID: 18434765 DOI: 10.1097/pap.0b013e31817145a9] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Tumors of the renal pelvis account for approximately 7% to 8% of all renal malignancies, greater than 90% of these are of urothelial (transitional cell) origin. These tumors more typically occur in the sixth to eight decade with a slight male preponderance. Varying risk factors for urothelial carcinomas of the upper tract are recognized including environmental and occupational hazards, chemotherapeutic exposure, and previous history of urinary bladder or ureteral carcinomas. Tumor multifocality is frequent and additional tumors may arise in the ureter, bladder, or on the contralateral side. The histopathologic nuances presented by urothelial carcinoma in this region are generally similar to those in the urinary bladder. Though the World Health Organization 2004/International Society of Urological Pathology system used in the bladder is customarily also employed for grading of urothelial tumors of this region, its prognostic significance at this site is not entirely clear as most tumors are treated with nephroureterectomy irrespective of the grade of the tumor. Histologic grade may be an independent prognostic factor in papillary pT1 tumors; however, most pT2 and higher stage tumors tend to be nonpapillary and of higher grade. Despite advances in treatment modalities with sophisticated endoscopic techniques, tumor stage remains the most important prognostic factor. There are several confounding issues related to staging such as the variable presence and thickness of subepithelial connective tissue and muscularis in the renal calyces, renal pelvis, and the ureter; intratubular pagetoid cancer spread (pTis vs. pT3); and assessing invasion in papillary neoplasms with endophytic or inverted growth. Careful gross examination with adequate sampling and understanding the microanatomy of the pelvicalyceal wall are crucial for accurate stage assignment. Poor fixation of large friable tumors and processing artifacts may compound difficulties in accurate staging. This review focuses on urothelial carcinoma of the upper tract highlighting issues related to its diagnosis, staging, and reporting.
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