1
|
Novokreshennih EE, Kolodkina AA, Bezlepkina OB. [DICER1 syndrome: clinical variety endocrine manifestations and features of diagnostics]. PROBLEMY ENDOKRINOLOGII 2023; 70:78-85. [PMID: 38796764 DOI: 10.14341/probl13383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 05/28/2024]
Abstract
DICER1 syndrome is a rare genetic disorder with the progressive development of malignant and non-malignant diseases in childhood. The cause of this syndrome is a dusfunction of the endoribonuclease DICER, which plays an important role in the processing of microRNAs with subsequent regulation of the control of the expression of oncogenes and tumor suppressor genes. Clinical manifestations of dyseropathies is very different and may include both endocrine manifestations - multinodular goiter, differentiated thyroid cancers, ovarian stromal tumors, pituitary blastoma, and non-endocrine formations - pleuropulmonary blastoma, cystic nephroma, pineoblastoma. The presence of somatic mutations of the DICER1 gene is a resultant stage in the pathogenesis of dyseropathies, determining the further path of oncogenesis. At present, DICER1 syndrome is diagnosed extremely rarely, which leads to late detection of the components of the disease in the patient, late diagnosis of neoplasms, lack of family counseling. Diagnosis at the early stages of the disease, the development of screening programs for the management of these patients allows minimizing the risks of developing more malignant, aggressive forms of the disease.
Collapse
|
2
|
Jain P, Prasad A, Jain S, Rahul KM. Cystic Nephroma and its Varied Management Scenarios: A Report of two Cases. J Indian Assoc Pediatr Surg 2021; 26:268-270. [PMID: 34385775 PMCID: PMC8323577 DOI: 10.4103/jiaps.jiaps_152_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/02/2020] [Accepted: 09/20/2020] [Indexed: 11/21/2022] Open
Abstract
Cystic nephroma is a rare benign cystic neoplasm of the kidney. The preoperative diagnosis with its malignant counterparts cystic partially differentiated nephroblastoma or cystic Wilms' tumor is not easy but is important when one is considering for nephron-sparing surgery.
Collapse
Affiliation(s)
- Prashant Jain
- Department of Paediatric Surgery and Pediatric Urology, BLK Center For Child Health, BLK Super Speciality Hospital, New Delhi, India
| | - Ashish Prasad
- Department of Paediatric Surgery and Pediatric Urology, BLK Center For Child Health, BLK Super Speciality Hospital, New Delhi, India
| | - Sarika Jain
- Department of Radiodiagnosis, Doda Imaging, Pusa Road, New Delhi, India
| | - Kanta M Rahul
- Department of Anesthesia, BLK Super Speciality Hospital, New Delhi, India
| |
Collapse
|
3
|
Baio R, Spiezia N, Schettini M. Cystic nephroma treated with nephron-sparing technique: A case report. Mol Clin Oncol 2021; 14:109. [PMID: 33859823 PMCID: PMC8042535 DOI: 10.3892/mco.2021.2271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 03/01/2021] [Indexed: 11/06/2022] Open
Abstract
Multilocular cystic nephroma is a rare benign kidney tumor, which is typically characterized by a unilateral, multicystic renal mass without solid elements. Cystic nephroma has a bimodal distribution and two-thirds of tumors involve children aged between 3 months and 2 years, with male predominance; a second peak affects the age group >30 years old, in which females are predominantly affected. The incidence rate for this rare tumor in patients aged 5-30 years is only 5%. The present study reports a case of a 31-year-old woman affected by a multilocular cystic nephroma in the upper pole of the right kidney, with direct tumor extension into the renal pelvis through a calyx. After a partial nephrectomy on the patient, the pathological examination confirmed a multilocular cystic nephroma in the right renal specimens.
Collapse
Affiliation(s)
- Raffaele Baio
- Department of Urology, University of Salerno, I-84081 Salerno, Italy
| | - Nicola Spiezia
- Department of Urology, Lourdes Clinic, I-80040 Massa di Somma, Italy
| | - Manlio Schettini
- Department of Urology, Lourdes Clinic, I-80040 Massa di Somma, Italy
| |
Collapse
|
4
|
Kaspar C, Reis H, Stehling F, Dirksen U, Hadaschik BA, Rehme C. [Cystic nephroma in a 15-month-old boy with DICER1 mutation]. Urologe A 2021; 60:776-779. [PMID: 33728475 DOI: 10.1007/s00120-021-01502-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 11/28/2022]
Abstract
Cystic nephroma is a rare tumor in childhood. Seventy percent of all cases are associated with DICER1-anomaly and therefore cystic nephroma represents the second most common tumor of all patients with DICER1 mutation. We present a case of a 15-month-old boy with a DICER1 mutation and cystic nephroma. Organ-sparing surgery was not possible. Due to higher prevalence of germ cell tumors, follow-up after nephrectomy is necessary until adulthood.
Collapse
Affiliation(s)
- Cordelia Kaspar
- Klinik für Urologie, Kinderurologie und Uroonkologie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Deutschland. .,Deutsches Konsortium für Translationale Krebsforschung, Essen, Deutschland.
| | - Henning Reis
- Institut für Pathologie, Universitätsmedizin Essen, Universität Duisburg-Essen, Essen, Deutschland.,Deutsches Konsortium für Translationale Krebsforschung, Essen, Deutschland
| | - Florian Stehling
- Zentrum für Kinder- und Jugendmedizin, Kinderklinik III, Universitätsklinikum Essen, Essen, Deutschland.,Deutsches Konsortium für Translationale Krebsforschung, Essen, Deutschland
| | - Uta Dirksen
- Zentrum für Kinder- und Jugendmedizin, Kinderklinik III, Universitätsklinikum Essen, Essen, Deutschland.,Deutsches Konsortium für Translationale Krebsforschung, Essen, Deutschland
| | - Boris A Hadaschik
- Klinik für Urologie, Kinderurologie und Uroonkologie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Deutschland.,Deutsches Konsortium für Translationale Krebsforschung, Essen, Deutschland
| | - Christian Rehme
- Klinik für Urologie, Kinderurologie und Uroonkologie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Deutschland.,Deutsches Konsortium für Translationale Krebsforschung, Essen, Deutschland
| |
Collapse
|
5
|
Han DS, Chalmers DJ, Greffe B, Garrington T, Partrick D, Lovell M, Schneider KW, Cost NG. A Cystic Renal Mass in the Setting of a Pneumothorax: More Than Meets the Eye? Urology 2021; 154:275-277. [PMID: 33571543 DOI: 10.1016/j.urology.2021.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/31/2021] [Indexed: 11/15/2022]
Abstract
DICER1 syndrome is a rare hereditary cancer predisposition syndrome that has relevance to pediatric urology providers due to its association with many various pediatric genitourinary malignancies. We describe the case of a pediatric patient who was eventually diagnosed with a pathogenic DICER1 germline variant after undergoing resection of a cystic nephroma and pleuropulmonary blastoma.
Collapse
Affiliation(s)
- Daniel S Han
- Department of Pediatric Urology, Children's Hospital Colorado, Aurora, CO.
| | - David J Chalmers
- Maine Medical Center Urology, Maine Medical Center, Portland, ME
| | - Brian Greffe
- Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO
| | - Timothy Garrington
- Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO
| | - David Partrick
- Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, CO
| | - Mark Lovell
- Department of Pathology, Children's Hospital Colorado, Aurora, CO
| | | | - Nicholas G Cost
- Department of Pediatric Urology, Children's Hospital Colorado, Aurora, CO
| |
Collapse
|
6
|
Robertson JC, Jorcyk CL, Oxford JT. DICER1 Syndrome: DICER1 Mutations in Rare Cancers. Cancers (Basel) 2018; 10:cancers10050143. [PMID: 29762508 PMCID: PMC5977116 DOI: 10.3390/cancers10050143] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/13/2018] [Accepted: 05/14/2018] [Indexed: 12/20/2022] Open
Abstract
DICER1 syndrome is a rare genetic disorder that predisposes individuals to multiple cancer types. Through mutations of the gene encoding the endoribonuclease, Dicer, DICER1 syndrome disrupts the biogenesis and processing of miRNAs with subsequent disruption in control of gene expression. Since the first description of DICER1 syndrome, case reports have documented novel germline mutations of the DICER1 gene in patients with cancers as well as second site mutations that alter the function of the Dicer protein expressed. Here, we present a review of mutations in the DICER1 gene, the respective protein sequence changes, and clinical manifestations of DICER1 syndrome. Directions for future research are discussed.
Collapse
Affiliation(s)
- Jake C Robertson
- Department of Biological Sciences, Boise State University, Boise, ID 83725-1515, USA.
| | - Cheryl L Jorcyk
- Department of Biological Sciences, Boise State University, Boise, ID 83725-1515, USA.
- Biomolecular Research Center, Boise State University, Boise, ID 83725-1511, USA.
| | - Julia Thom Oxford
- Department of Biological Sciences, Boise State University, Boise, ID 83725-1515, USA.
- Biomolecular Research Center, Boise State University, Boise, ID 83725-1511, USA.
| |
Collapse
|
7
|
Multicystic nephroma masquerading as hydatid cyst: a diagnostic challenge. BMC Urol 2017; 17:17. [PMID: 28284198 PMCID: PMC5346185 DOI: 10.1186/s12894-017-0208-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 03/07/2017] [Indexed: 01/17/2023] Open
Abstract
Background Multicystic nephroma is an uncommon, non-familial renal neoplasm that is usually benign. About 200 cases of this lesion have been described in the literature. Case presentation We report on a Sudanese child who presented at the age of two and a half years with an abdominal mass, clinical and radiological features favored the diagnosis of hydatid cyst which is endemic in this African tropical country, and the diagnosis of multicystic nephroma was only possible after histopathological examination. Conclusion Multicystic nephroma is a rare benign tumour with an excellent prognosis. Clinical and radiological differentiation of multicystic nephroma from hydatid cyst is difficult. Thus, histopathological examination of the surgical specimens seems to be the only feasible method of making the correct diagnosis.
Collapse
|
8
|
Statoua M, Yddousalah O, Ziouziou I, Karmouni T, Khader KE, Koutani A, Andaloussi A. Néphrome kystique multiloculaire de l’adulte: à propos d’un cas et revue de la littérature. AFRICAN JOURNAL OF UROLOGY 2015. [DOI: 10.1016/j.afju.2014.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
9
|
Kurian JJ, Ninan PJ. A rare case of bilateral cystic partially differentiated nephroblastoma recurring as bilateral cystic Wilms tumour. BMJ Case Rep 2015; 2015:bcr-2015-209771. [PMID: 25878237 DOI: 10.1136/bcr-2015-209771] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Childhood cystic partially differentiated nephroblastoma (CPDN) is an uncommon renal neoplasm. Bilateral CPDN or CPDN co-existing with a cystic nephroma/Wilms tumour is extremely rare. Treatment of CPDN is by complete surgical excision. Although local recurrences are uncommon, distant metastases have not been described. We present a case of bilateral CPDN that, after complete excision, recurred as bilateral cystic Wilms tumour. To the best of our knowledge, this is the first reported case in the literature where a bilateral CPDN has recurred as bilateral Wilms tumour.
Collapse
Affiliation(s)
- Jujju Jacob Kurian
- Department of Paediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pradeep Joseph Ninan
- Department of Paediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| |
Collapse
|
10
|
Sun BL, Abern M, Garzon S, Setty S. Cystic Nephroma/Mixed Epithelial Stromal Tumor. Int J Surg Pathol 2014; 23:238-42. [DOI: 10.1177/1066896914563391] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cystic nephroma (CN) is a rare, benign, renal neoplasm composed of epithelial and stromal elements. Only about 200 cases have been reported since 1892 and recurrence has rarely been observed. We report a 32-year-old Hispanic woman, with a history of a right, complex cystic, renal mass treated by robotic decortication 2 years ago, who presented with flank pain, hematuria, and recurrent urinary tract infection. A magnetic resonance imaging study showed a 3.4-cm multicystic lesion with thickened septa and enhancement at the right kidney. The partial nephrectomy specimen revealed a well-circumscribed, multicystic tumor abutting the renal pelvis, with thick septa and smooth walls, filled with clear fluid. Microscopic examination showed variably sized cysts lined by cuboidal epithelium with focal hobnailing, without significant cytologic atypia and mitosis. The epithelial lining was positive for CK19, high molecular weight cytokeratin, and α-methylacyl-CoA racemase suggesting a primitive tubular epithelial phenotype. Primitive glomeruli-like structures were also present. The ovarian-like stroma was condensed around the cysts and was variably cellular with areas of muscle differentiation and thick-walled vessels. The stroma was positive for desmin, estrogen receptor, progesterone receptor, and CD10. We suggest that CN represents a variable mixture of epithelial and stromal elements, immature glomerular, tubular, muscle, and vascular elements, which may be present in variable proportions creating a spectrum of lesions previously described as CN and mixed epithelial and stromal tumors (MEST). This case emphasizes that CN/MEST clinically/radiologically mimics other cystic renal neoplasms, especially cystic renal cell carcinoma and tubulocystic carcinoma, necessitating histopathological examination and immunohistochemial studies for definitive diagnosis. Additionally, CN has the tendency to recur when not completely excised initially.
Collapse
Affiliation(s)
- Belinda L. Sun
- Department of Pathology, University of Illinois Hospital & Health Sciences System, Chicago, IL, USA
| | - Michael Abern
- Department of surgery, University of Illinois Hospital & Health Sciences System, Chicago, IL, USA
| | - Steven Garzon
- Department of Pathology, University of Illinois Hospital & Health Sciences System, Chicago, IL, USA
| | - Suman Setty
- Department of Pathology, University of Illinois Hospital & Health Sciences System, Chicago, IL, USA
| |
Collapse
|
11
|
Chang CP, Li JR, Yang CS, Ou YC, Cheng CL. Multilocular cystic nephroma: A case report and review of the literature. UROLOGICAL SCIENCE 2014. [DOI: 10.1016/j.urols.2013.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
12
|
Dong B, Wang Y, Zhang J, Fu Y, Wang G. Multilocular cystic nephroma treated with laparoscopic nephron-sparing surgery: A case report. Can Urol Assoc J 2014; 8:E545-7. [PMID: 25210560 DOI: 10.5489/cuaj.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Multilocular cystic nephroma is a relatively rare benign tumour of the kidney, which usually presents as a unilateral multicystic renal mass without solid elements. The lesions typically have a bimodal age, with peak incidence in male children under 24 months and another one in women over 40 old. We present an unusual case report of multilocular cystic nephroma in the right kidney in a 30-year-old male. Laparoscopic partial nephrectomy was performed. The pathologic examination confirmed a multi-locular cystic nephroma in the right renal specimens. We present the image findings, pathological features, treatment alternatives and a review of the literature.
Collapse
Affiliation(s)
- Biao Dong
- Department of Urology, First Hospital of Jilin University, Jilin, China
| | - Yuantao Wang
- Department of Urology, First Hospital of Jilin University, Jilin, China
| | - Jianjian Zhang
- Department of Hepatic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yaowen Fu
- Department of Urology, First Hospital of Jilin University, Jilin, China
| | - Gang Wang
- Department of Urology, First Hospital of Jilin University, Jilin, China
| |
Collapse
|
13
|
Wilkinson C, Palit V, Bardapure M, Thomas J, Browning AJ, Gill K, Biyani CS. Adult multilocular cystic nephroma: Report of six cases with clinical, radio-pathologic correlation and review of literature. Urol Ann 2013; 5:13-7. [PMID: 23662002 PMCID: PMC3643315 DOI: 10.4103/0974-7796.106958] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Accepted: 06/17/2011] [Indexed: 11/14/2022] Open
Abstract
Background: Cystic renal neoplasms of the kidney can be benign or malignant. Multicystic nephroma (MCN) represents a rare benign cystic lesion of the kidney, which usually presents as a unilateral multicystic renal mass without solid elements. According to the World Health Organization (WHO) classification of the renal neoplasms, it is grouped along with mixed epithelial–stromal tumor of the kidney. Materials and Methods: We report a retrospective review of six cases of MCN of kidney. Patient demographics, imaging findings, operative details and final histology were recorded. Results: All patients had suspicious/malignant features on radiological examination, leading to a radical nephrectomy. However, microscopically these lesions were lined by cuboidal epithelium, and in a few places hobnail epithelium. No cells with clear cytoplasm, blastemal or immature elements were seen. In one case, foci of inflammatory cells and histiocytes were present. Conclusions: MCN is a benign cystic lesion and clinical presentations are nonspecific with symptoms such as abdominal pain, hematuria and urinary tract infection. These nonspecific clinical presentations and confusing radiological features create difficult preoperative differentiation from malignant cystic renal neoplasms.
Collapse
Affiliation(s)
- Christopher Wilkinson
- Department of Radiology, Pinderfields General Hospital, Wakefield, West Yorkshire, UK
| | | | | | | | | | | | | |
Collapse
|
14
|
Multilocular cystic nephroma of the kidney in a young adult: Case report. AFRICAN JOURNAL OF UROLOGY 2009. [DOI: 10.1007/s12301-009-0046-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
15
|
Kuzgunbay B, Turunc T, Bolat F, Kilinc F. Adult cystic nephroma: a case report and a review of the literature. Urol Oncol 2008; 27:407-9. [PMID: 18555707 DOI: 10.1016/j.urolonc.2008.02.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Revised: 02/19/2008] [Accepted: 02/28/2008] [Indexed: 11/27/2022]
Abstract
A 23-year old women who underwent radical nephrectomy due to right renal mass is presented. The histopathological examination is reported as adult cystic nephroma, a rare benign lesion of the kidney. The epidemiology, differential diagnosis, histopathological features, and treatment alternatives are discussed and the literature is reviewed.
Collapse
Affiliation(s)
- Baris Kuzgunbay
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey.
| | | | | | | |
Collapse
|
16
|
Turbiner J, Amin MB, Humphrey PA, Srigley JR, De Leval L, Radhakrishnan A, Oliva E. Cystic nephroma and mixed epithelial and stromal tumor of kidney: a detailed clinicopathologic analysis of 34 cases and proposal for renal epithelial and stromal tumor (REST) as a unifying term. Am J Surg Pathol 2007; 31:489-500. [PMID: 17414095 DOI: 10.1097/pas.0b013e31802bdd56] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Cystic nephroma (CN) and mixed epithelial and stromal tumor (MEST) are rare benign renal neoplasms that have overlapping clinical and morphologic features, including predominance in middle-aged women, variably cystic architecture, eosinophilic cells, and hobnail cells lining the cysts and ovarian-type stroma. The aim of this study was to analyze and compare the histologic features and immunohistochemical profile of these tumors. We studied 34 cases from 5 large academic institutions. Twenty tumors were diagnosed as CNs, 18 in women and 2 in men, their age ranged from 24 to 63 (mean 48; median 50) years. Fourteen tumors were diagnosed as MESTs, all in women, their age ranged from 26 to 84 (mean 52; median 51) years. Histologically, all tumors were well-circumscribed except for one MEST. The stromal/epithelial ratio was approximately 2.3 in MESTs versus 0.3 in CNs; cellular ovarian-type stroma composed 45% of the stroma in MESTs and 12% of the stroma of CNs. Stromal hyalinization was prominent in both. Five MESTs showed stromal luteinization. In the epithelial component, the relative amount of large cysts, medium to small cysts, and phyllodes-type glands was: 65%/25%/10% in CNs versus 25%/40%/35% in MESTs. The epithelial component ranged from flat to cuboidal to hobnail cells in both types of tumors. No significant atypia of either component was seen, although the epithelial cells showed reactive changes. Immunohistochemical stains for estrogen receptors and progesterone receptors showed 62% and 85% positivity in the stromal component of MESTs versus 19% and 40% in CNs. CD10 positivity was seen in 77% of MESTs versus 50% of CNs, calretinin was seen in 69% of MESTs versus 41% of CNs, and inhibin in 42% of MESTs versus 36% of CNs, although the staining was focal. Follow-up in both categories of tumors (mean 3.2 y, median 3 y for CNs and mean 2.5 y, median of 2 y for MESTs) showed no evidence of recurrence or metastases in keeping with their benign nature. This study highlights the remarkable similarity between CN and MEST in sex predilection, age distribution, and morphologic attributes of both the epithelial and stromal components and immunohistochemical profile albeit with variation in individual categories with higher prevalence of stromal to epithelial ratio, prominent ovarian stroma, smaller cysts with phyllodes glands pattern and stromal luteinization being more common in MEST; and large cysts, thin septae and low stromal to epithelial ratio in CN. The presence of ovarian-type stroma and müllerian related immunohistochemical markers raises the possibility that these tumors may originate from müllerian remnants misplaced during embryogenesis. On the basis of detailed morphologic analysis of this series of CN and MEST, we propose a unifying term of "renal epithelial and stromal tumor" (REST) to encompass the spectrum of findings observed in these tumors at least until new molecular studies can prove or disprove this challenging hypothesis.
Collapse
Affiliation(s)
- Julia Turbiner
- Pathology Department, Massachusetts General Hospital, Boston, MA 02114, USA.
| | | | | | | | | | | | | |
Collapse
|
17
|
Bouhafs A, Cherradi N, Lamaalmi N, Belkacem R, Barahioui M. An unusual case of multilocular cystic nephroma with prominent renal pelvis involvement. Int J Urol 2006; 13:436-8. [PMID: 16734866 DOI: 10.1111/j.1442-2042.2006.01330.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Multilocular cystic nephroma (MCN) is a relatively rare, benign tumor of uncertain etiology. It typically arises from the renal parenchyma and is often treated with nephrectomy. We report a case of MCN with unusual prominent renal pelvis extension. A left nephrectomy was performed. A multilocular cystic lesion was found in the removed specimen, which had a direct tumor extension into the renal pelvis. There were no signs of malignancy. The tumor extension into the renal pelvis has been found in very few reports. This growth pattern might be one of the characteristics of this benign renal tumor.
Collapse
Affiliation(s)
- Amine Bouhafs
- Pediatric Urology Department, Children's Hospital, Rabat, Morocco.
| | | | | | | | | |
Collapse
|
18
|
Lenz MP, Warmann SW, Scheel-Walter HG, Schäfer J, Wehrmann M, Hacker HW, Fuchs J. A complicated case of bilateral cystic nephroma in a 16-month-old boy. Pediatr Surg Int 2005; 21:1011-4. [PMID: 16273373 DOI: 10.1007/s00383-005-1544-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2005] [Indexed: 10/25/2022]
Abstract
We describe a case of a progressive bilateral cystic nephroma (BCN) in a child undergoing a multistaged surgical procedure. After partial resection of the left sided tumor, a progress occurred on that side and the left kidney had to be removed 10 weeks later. After 35 months a tumor progression was observed on the right side together with an ureteral obstruction leading to a decreased renal function. In a third operation a complete tumor resection on the right side was achieved through longitudinal partial nephrectomy, reconstruction of the renal pelvis, and reanastomosis of the reconstructed pelvis and ureter. The patient showed no evidence of the disease at 28 months of follow-up. The presented case provides an evidence that in BCN a tumor progress may occur after multistaged surgical approaches. A single-staged complete tumor resection with renal salvage techniques seems indicated.
Collapse
Affiliation(s)
- Monika P Lenz
- Department of Pediatric Surgery, University of Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany.
| | | | | | | | | | | | | |
Collapse
|