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Chaurasia A, Turkbey EB, Firouzabadi FD, Singh S, Samimi S, Gopal N, Millo C, Ball MW, Linehan WM, Malayeri AA. Imaging finding of renal masses associated with pathogenic variation in succinate dehydrogenase subunit B gene. Clin Imaging 2024; 115:110280. [PMID: 39260085 DOI: 10.1016/j.clinimag.2024.110280] [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: 05/13/2024] [Revised: 08/26/2024] [Accepted: 09/02/2024] [Indexed: 09/13/2024]
Abstract
PURPOSE Succinate dehydrogenase (SDH)-deficient renal cell carcinoma (RCC) is a newly defined, rare subtype of renal cancer, associated with pathogenic variations in the Succinate Dehydrogenase Subunit B (SDHB) gene. Our aim is to investigate the imaging findings of SDHB-associated renal tumors, utilizing cross-sectional and FDG-PET imaging in patients with pathogenic variations in SDHB gene, to facilitate accurate tumor characterization. METHODS Twenty SDH-deficient tumors from 16 patients with pathogenic variations in SDHB gene were retrospectively evaluated using cross-sectional and FDG-PET imaging. Clinical findings such as demographics, family history, extra-renal findings and metastases were recorded. Tumor imaging characteristics on CT/MRI included were laterality, size, homogeneity, morphology, margins, internal content, T1/T2 signal intensity, enhancement features, and restricted diffusion. RESULTS Sixteen patients (median age 31 years, IQR 19-41, 8 males) were identified with 68.8 % of patients having a known family history of SDHB variation. 81.3 % of lesions were solitary and majority were solid (86.7 % on CT, 87.5 % on MRI) with well-defined margins in >62.5 % of lesions, without evidence of internal fat, calcifications, or vascular invasion. 100 % of lesions demonstrated restricted diffusion and avid enhancement, with degree >75 % for most lesions on CT and MRI. On FDG-PET, all renal masses showed increased radiotracer uptake. 43.8 % of patients demonstrated extra-renal manifestations and 43.8 % had distant metastasis. CONCLUSION SDHB-associated RCC is predominantly noted in young patients with no gender predilection. On imaging, SDH-deficient RCC are frequently unilateral, solitary, and solid with well-defined margins demonstrating avid enhancement with variability in enhancement pattern and showing restricted diffusion.
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Affiliation(s)
- Aditi Chaurasia
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bldg. 10, 10 Center Drive, Bethesda, MD 20892, USA
| | - Evrim B Turkbey
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Fatemeh Dehghani Firouzabadi
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Shiva Singh
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Safa Samimi
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Nikhil Gopal
- Depatment of Urology, College of Medicine, University of Tennessee, 910 Madison Avenue, Memphis, TN 38163, USA
| | - Corina Millo
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Mark W Ball
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bldg. 10, 10 Center Drive, Bethesda, MD 20892, USA
| | - W Marston Linehan
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bldg. 10, 10 Center Drive, Bethesda, MD 20892, USA
| | - Ashkan A Malayeri
- Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA.
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2
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Corral de la Calle MÁ, Encinas de la Iglesia J, Fernández Pérez GC, Fraino A, Repollés Cobaleda M. Multiple and hereditary renal tumors: a review for radiologists. RADIOLOGIA 2024; 66:132-154. [PMID: 38614530 DOI: 10.1016/j.rxeng.2024.03.001] [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: 01/12/2023] [Accepted: 03/19/2023] [Indexed: 04/15/2024]
Abstract
80% of renal carcinomas (RC) are diagnosed incidentally by imaging. 2-4% of "sporadic" multifocality and 5-8% of hereditary syndromes are accepted, probably with underestimation. Multifocality, young age, familiar history, syndromic data, and certain histologies lead to suspicion of hereditary syndrome. Each tumor must be studied individually, with a multidisciplinary evaluation of the patient. Nephron-sparing therapeutic strategies and a radioprotective diagnostic approach are recommended. Relevant data for the radiologist in major RC hereditary syndromes are presented: von-Hippel-Lindau, Chromosome-3 translocation, BRCA-associated protein-1 mutation, RC associated with succinate dehydrogenase deficiency, PTEN, hereditary papillary RC, Papillary thyroid cancer- Papillary RC, Hereditary leiomyomatosis and RC, Birt-Hogg-Dubé, Tuberous sclerosis complex, Lynch, Xp11.2 translocation/TFE3 fusion, Sickle cell trait, DICER1 mutation, Hereditary hyperparathyroidism and jaw tumor, as well as the main syndromes of Wilms tumor predisposition. The concept of "non-hereditary" familial RC and other malignant and benign entities that can present as multiple renal lesions are discussed.
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Affiliation(s)
| | | | | | - A Fraino
- Servicio de Radiodiagnóstico, Complejo Asistencial de Ávila, Ávila, Spain
| | - M Repollés Cobaleda
- Servicio de Radiodiagnóstico, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
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3
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Characteristic Chest Computed Tomography Findings for Birt-Hogg-Dube Syndrome Indicating Requirement for Genetic Evaluation. Diagnostics (Basel) 2023; 13:diagnostics13020198. [PMID: 36673012 PMCID: PMC9858281 DOI: 10.3390/diagnostics13020198] [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: 12/05/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
Background: Chest computed tomography (CT) findings are important for identifying Birt−Hogg−Dube (BHD) syndrome. However, the predictive power of classical criteria for chest CT findings is weak. Here, we aimed to identify more specific chest CT findings necessitating genetic examination for FLCN gene mutations. Methods: From June 2016 to December 2017, we prospectively enrolled 21 patients with multiple bilateral and basally located lung cysts on chest CT with no other apparent cause, including cases with and without spontaneous primary pneumothorax. All enrolled patients underwent FLCN mutation testing for diagnosis confirmation. Results: BHD was diagnosed in 10 of 21 enrolled patients (47.6%). There were no differences in clinical features between the BHD and non-BHD groups. Maximal cyst diameter was significantly greater in the BHD group (mean ± standard deviation; 4.1 ± 1.1 cm) than in the non-BHD group (1.6 ± 0.9 cm; p < 0.001). Diversity in cyst size was observed in 100.0% of BHD cases and 18.2% of non-BHD cases (p = 0.001). Morphological diversity was observed in 100.0% of BHD cases and 54.6% of non-BHD cases (p = 0.054). Areas under the receiver operating characteristic curves for predicting FLCN gene mutations were 0.955 and 0.909 for maximal cyst diameter and diversity in size, respectively. The optimal cut-off value for maximal diameter FLCN mutations prediction was 2.1 cm (sensitivity: 99%; specificity: 82%). Conclusions: Reliable chest CT features suggesting the need for FLCN gene mutations screening include variations in cyst size and the presence of cysts > 2.1 cm in diameter, predominantly occurring in the bilateral basal lungs.
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4
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Sharma R, Kannourakis G, Prithviraj P, Ahmed N. Precision Medicine: An Optimal Approach to Patient Care in Renal Cell Carcinoma. Front Med (Lausanne) 2022; 9:766869. [PMID: 35775004 PMCID: PMC9237320 DOI: 10.3389/fmed.2022.766869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 04/11/2022] [Indexed: 12/24/2022] Open
Abstract
Renal cell cancer (RCC) is a heterogeneous tumor that shows both intra- and inter-heterogeneity. Heterogeneity is displayed not only in different patients but also among RCC cells in the same tumor, which makes treatment difficult because of varying degrees of responses generated in RCC heterogeneous tumor cells even with targeted treatment. In that context, precision medicine (PM), in terms of individualized treatment catered for a specific patient or groups of patients, can shift the paradigm of treatment in the clinical management of RCC. Recent progress in the biochemical, molecular, and histological characteristics of RCC has thrown light on many deregulated pathways involved in the pathogenesis of RCC. As PM-based therapies are rapidly evolving and few are already in current clinical practice in oncology, one can expect that PM will expand its way toward the robust treatment of patients with RCC. This article provides a comprehensive background on recent strategies and breakthroughs of PM in oncology and provides an overview of the potential applicability of PM in RCC. The article also highlights the drawbacks of PM and provides a holistic approach that goes beyond the involvement of clinicians and encompasses appropriate legislative and administrative care imparted by the healthcare system and insurance providers. It is anticipated that combined efforts from all sectors involved will make PM accessible to RCC and other patients with cancer, making a tremendous positive leap on individualized treatment strategies. This will subsequently enhance the quality of life of patients.
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Affiliation(s)
- Revati Sharma
- Fiona Elsey Cancer Research Institute, Ballarat Central Technology Central Park, Ballarat Central, VIC, Australia
- School of Science, Psychology and Sport, Federation University, Mt Helen, VIC, Australia
| | - George Kannourakis
- Fiona Elsey Cancer Research Institute, Ballarat Central Technology Central Park, Ballarat Central, VIC, Australia
- School of Science, Psychology and Sport, Federation University, Mt Helen, VIC, Australia
| | - Prashanth Prithviraj
- Fiona Elsey Cancer Research Institute, Ballarat Central Technology Central Park, Ballarat Central, VIC, Australia
- School of Science, Psychology and Sport, Federation University, Mt Helen, VIC, Australia
| | - Nuzhat Ahmed
- Fiona Elsey Cancer Research Institute, Ballarat Central Technology Central Park, Ballarat Central, VIC, Australia
- School of Science, Psychology and Sport, Federation University, Mt Helen, VIC, Australia
- Centre for Reproductive Health, Hudson Institute of Medical Research and Department of Translational Medicine, Monash University, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
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5
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Tuberous Sclerosis Complex (TSC): Renal and Extrarenal Imaging. Acad Radiol 2022; 29:439-449. [PMID: 33487538 DOI: 10.1016/j.acra.2020.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/22/2020] [Accepted: 12/26/2020] [Indexed: 11/21/2022]
Abstract
Tuberous sclerosis complex is a multiorgan syndrome manifesting with several benign and malignant tumors. Complications arising from renal abnormalities are a leading cause of death in patients with tuberous sclerosis complex. Renal cell carcinoma is relatively uncommon, occurring in 2%-4% of patients with tuberous sclerosis complex syndrome, but nonetheless can significantly contribute to morbidity and mortality. Extrarenal manifestations of tuberous sclerosis complex, including within the chest, abdomen and central nervous system, aid in diagnosis. Pathogenesis and management are also discussed, including the importance of the types of renal masses found in these patients.
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6
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Webster BR, Rompre-Brodeur A, Daneshvar M, Pahwa R, Srinivasan R. Kidney cancer: from genes to therapy. Curr Probl Cancer 2021; 45:100773. [PMID: 34261604 DOI: 10.1016/j.currproblcancer.2021.100773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022]
Abstract
Renal cell carcinoma incidence is rising worldwide with increasing subtype stratification by the World Health Organization. Each subtype has unique genetic alterations, cell biology changes and clinical findings. Such genetic alterations offer the potential for individualized therapeutic approaches that are rapidly progressing. This review highlights the most common subtypes of renal cell carcinoma, including both hereditary and sporadic forms, with a focus on genetic changes, clinical findings and ongoing clinical trials.
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Affiliation(s)
- Bradley R Webster
- Center for Cancer Research, Urologic Oncology Branch, National Cancer Institute/NIH, 10 Center Drive, CRC Room 2W-5940, Bethesda, MD 20892, USA
| | - Alexis Rompre-Brodeur
- Center for Cancer Research, Urologic Oncology Branch, National Cancer Institute/NIH, 10 Center Drive, CRC Room 2W-5940, Bethesda, MD 20892, USA
| | - Michael Daneshvar
- Center for Cancer Research, Urologic Oncology Branch, National Cancer Institute/NIH, 10 Center Drive, CRC Room 2W-5940, Bethesda, MD 20892, USA
| | - Roma Pahwa
- Center for Cancer Research, Urologic Oncology Branch, National Cancer Institute/NIH, 10 Center Drive, CRC Room 2W-5940, Bethesda, MD 20892, USA
| | - Ramaprasad Srinivasan
- Center for Cancer Research, Urologic Oncology Branch, National Cancer Institute/NIH, 10 Center Drive, CRC Room 2W-5940, Bethesda, MD 20892, USA.
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7
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Covello B, Kaufman S, Whittington E, Enrizo O. A case of bilateral renal oncocytomas in the setting of Birt-Hogg-Dube syndrome. Radiol Case Rep 2021; 16:1249-1254. [PMID: 33868530 PMCID: PMC8041656 DOI: 10.1016/j.radcr.2021.02.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/03/2022] Open
Abstract
Birt-Hogg-Dube syndrome is a rare autosomal dominant disorder characterized by pulmonary cysts, renal tumors, and dermal lesions. This syndrome results from a mutation in the gene folliculin, located on chromosome 17p11.2. Herein, a case is described in which the presence of bilateral renal oncocytomas led to the diagnosis of Birt-Hogg-Dube syndrome via an interdisciplinary effort by radiology, pathology, and primary care medicine. No radiographic features alone are sufficient to confirm the diagnosis of Birt-Hogg-Dube. A high index of suspicion must be maintained by both the pathologist and radiologist in the appropriate clinical setting.
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Affiliation(s)
- Brian Covello
- Department of Interventional Radiology, Kendall Regional Medical Center, 11750 SW 40th St, Miami, FL 33175, USA
- Corresponding author.
| | - Sean Kaufman
- Department of Pathology, Kendall Regional Medical Center, 11750 SW 40th St, Miami, FL 33175, USA
| | - Elizabeth Whittington
- Department of Pathology, Kendall Regional Medical Center, 11750 SW 40th St, Miami, FL 33175, USA
| | - Orlando Enrizo
- Department of Interventional Radiology, Kendall Regional Medical Center, 11750 SW 40th St, Miami, FL 33175, USA
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8
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Tanaka T, Kawashima A, Marukawa Y, Kitayama T, Masaoka Y, Kojima K, Iguchi T, Hiraki T, Kanazawa S. Imaging evaluation of hereditary renal tumors: a pictorial review. Jpn J Radiol 2021; 39:619-632. [PMID: 33759057 DOI: 10.1007/s11604-021-01109-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/10/2021] [Indexed: 11/28/2022]
Abstract
More than 10 hereditary renal tumor syndromes (HRTSs) and related germline mutations have been reported with HRTS-associated renal and extrarenal manifestations with benign and malignant tumors. Radiologists play an important role in detecting solitary or multiple renal masses with or without extrarenal findings on imaging and may raise the possibility of an inherited predisposition to renal cell carcinoma, providing direction for further screening, intervention and surveillance of the patients and their close family members before the development of potentially lethal renal and extrarenal tumors. Renal cell carcinomas (RCCs) associated with von Hippel-Lindau disease are typically slow growing while RCCs associated with HRTSs, such as hereditary leiomyomatosis and renal cell carcinoma syndrome, are highly aggressive. Therefore, radiologists need to be familiar with clinical and imaging findings of renal and extrarenal manifestations of HRTSs. This article reviews clinical and imaging findings for the evaluation of patients with well-established HRTSs from a radiologist's perspective to facilitate the clinical decision-making process for patient management.
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Affiliation(s)
- Takashi Tanaka
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
| | - Akira Kawashima
- Department of Radiology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Yohei Marukawa
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
| | - Takahiro Kitayama
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
| | - Yoshihisa Masaoka
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
| | - Katsuhide Kojima
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
| | - Toshihiro Iguchi
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
| | - Takao Hiraki
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
| | - Susumu Kanazawa
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
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9
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Walker SM, Gautam R, Turkbey B, Malayeri A, Choyke PL. Update on Hereditary Renal Cancer and Imaging Implications. Radiol Clin North Am 2020; 58:951-963. [PMID: 32792126 DOI: 10.1016/j.rcl.2020.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Up to 8% of renal cancers are thought to have a hereditary component. Several hereditary renal cancer syndromes have been identified over the last few decades. It is important for the radiologist to be aware of findings associated with hereditary renal cancer syndromes to detect tumors early, enroll patients in appropriate surveillance programs, and improve outcomes for the patient and affected family members. This review discusses from a radiologist's perspective well-known hereditary renal cancer syndromes and emerging genetic mutations associated with renal cancer that are less well characterized, focusing on imaging features and known associations.
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Affiliation(s)
- Stephanie M Walker
- Molecular Imaging Program, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Rabindra Gautam
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Baris Turkbey
- Molecular Imaging Program, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Ashkan Malayeri
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Peter L Choyke
- Molecular Imaging Program, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
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10
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Carlo MI, Hakimi AA, Stewart GD, Bratslavsky G, Brugarolas J, Chen YB, Linehan WM, Maher ER, Merino MJ, Offit K, Reuter VE, Shuch B, Coleman JA. Familial Kidney Cancer: Implications of New Syndromes and Molecular Insights. Eur Urol 2019; 76:754-764. [PMID: 31326218 PMCID: PMC7673107 DOI: 10.1016/j.eururo.2019.06.015] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/12/2019] [Indexed: 02/07/2023]
Abstract
CONTEXT Hereditary cases account for about 5% of all cases of renal cell carcinoma (RCC). With advances in next-generation sequencing, several new hereditary syndromes have been described in the last few years. OBJECTIVE To review and summarise the recent preclinical and clinical literature in hereditary renal cancer. EVIDENCE ACQUISITION A systematic review of the literature was performed in November 2018 using PubMed and OMIM databases, with an emphasis on kidney cancer, genetics and genomics, clinical criteria, and management. EVIDENCE SYNTHESIS Several autosomal dominant hereditary RCC syndromes have been described, including those related to germline pathogenic variants in VHL, MET, FH, TSC1/TSC2, FLCN, SDHA/B/C/D, BAP1, CDC73, and MITF. Clinical spectrum of SDH, BAP1, and MITF is still being defined, although these appear to be associated with a lower incidence of RCC. FH and likely BAP1 RCC are associated with more aggressive disease. Preclinical and clinical studies show that using systemic therapy that exploits specific genetic pathways is a promising strategy. CONCLUSIONS There are several well-described hereditary RCC syndromes, as well as recently identified ones, for which the full clinical spectrum is yet to be defined. In the new era of precision medicine, identification of these syndromes may play an important role in management and systemic treatment selection. PATIENT SUMMARY This review covers updates in the diagnosis and management of familial kidney cancer syndromes. We describe updates in testing and management of the most common syndromes such as von Hippel-Lindau, and hereditary leiomyomatosis and renal cell carcinoma. We also provide insights into recently described familial kidney cancer syndromes.
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Affiliation(s)
- Maria I Carlo
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - A Ari Hakimi
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Grant D Stewart
- Department of Surgery, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | | | | | - Ying-Bei Chen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - W Marston Linehan
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Eamonn R Maher
- Department of Surgery, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; Department of Medical Genetics, University of Cambridge and NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Cenre, Cambridge, UK
| | - Maria J Merino
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kenneth Offit
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Brian Shuch
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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11
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de Cássio Zequi S, da Costa WH, Korkes F, dos Reis RB, Busato WFS, Matheus WE, da Silva Neto DCV, de Almeida e Paula F, Carvalhal GF, Nogueira L, de Carvalho Fernandes R, Silva AGE, Sasse AD, Fay AP, Jardim DL, Bastos DA, da Rosa DAR, Wierman E, Kater F, Schutz FA, Maluf FC, de Oliveira FNG, Morbeck IAP, Rinck JA, da Trindade KM, Maia MC, Souza VC, Monteiro FSM, Soares A. Renal cell cancer treatment: an expert panel recommendation from the Latin American cooperative group-genitourinary and the Latin American renal cancer group: focus on surgery. Ther Adv Urol 2019; 11:1756287219872324. [PMID: 31523281 PMCID: PMC6734614 DOI: 10.1177/1756287219872324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 07/28/2019] [Indexed: 12/24/2022] Open
Abstract
Background: Renal cell cancer (RCC) is one of the 10 most common cancers in the world,
and its incidence is increasing, whereas mortality is declining only in
developed countries. Therefore, two collaborative groups, The Latin American
Oncology Cooperative Group-Genitourinary Section (LACOG-GU) and the Latin
American Renal Cancer Group (LARCG), held a consensus meeting to develop
this guideline. Methods: Issues (134) related to the treatment of RCC were previously formulated by a
panel of experts. The voting panel comprised 26 specialists (urologists and
medical oncologists) from the LACOG-GU/LARCG. A consensus was reached if 75%
agreement was achieved. If there was less concordance, a new discussion was
undertaken, and a consensus was determined by the most votes after a second
voting session. Results: The expert meeting provided recommendations that were in line with the global
literature; 75.0% of the recommendations made by the panel of experts were
evidence-based level A, 22.5% of the recommendations were level B, and 2.5%
of the recommendations were level D. Conclusions: This review suggests recommendations for the surgical treatment of RCC
according to the LACOG-GU/LARCG experts.
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Affiliation(s)
| | | | - Fernando Korkes
- Hospital Israelita Albert Einstein, São Paulo,
Brazil
- ABC Medical School, Santo André, Brazil
| | | | | | | | | | | | - Gustavo Franco Carvalhal
- Escola de Medicina e Hospital São Lucas da
Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre,
Brazil
| | - Lucas Nogueira
- Hospital das Clínicas da Universidade Federal
de Minas Gerais, Belo Horizonte, Brazil
| | - Roni de Carvalho Fernandes
- Faculdade de Ciências Médicas da Santa Casa de
São Paulo, Brazil
- Hospital Central da Santa Casa de Misericórdia
de São Paulo, Brazil
| | | | | | - André P. Fay
- Escola de Medicina e Hospital São Lucas da
Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre,
Brazil
- Grupo Oncoclínicas, Porto Alegre, Brazil
| | | | | | | | | | - Fabio Kater
- Beneficência Portuguesa de São Paulo,
Brazil
| | | | - Fernando Cotait Maluf
- Hospital Israelita Albert Einstein, São Paulo,
Brazil
- Beneficência Portuguesa de São Paulo,
Brazil
- Hospital Santa Lúcia, Brasilia, Brazil
| | | | | | | | - Karine Martins da Trindade
- Hospital São Carlos/Oncocentro, Fortaleza,
Brazil
- Santa Casa de Misericórdia de Fortaleza,
Fortaleza, Brazil
| | | | | | | | - Andrey Soares
- Hospital Israelita Albert Einstein, São Paulo,
Brazil
- Centro Paulista de Oncologia, São Paulo,
Brazil
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Abstract
PURPOSE OF THE REVIEW We present an updated report of renal medullary carcinoma (RMC), a rare and aggressive condition. RECENT FINDINGS There is a majority of male patients, of African descent, in the second or third decade of life. In differential diagnosis, other tumors, such as malignant rhabdoid tumor (MRT), vinculin-anaplastic lymphoma kinase (VCL-ALK) translocation renal cell carcinoma, and collecting duct carcinoma, may present difficulties. Abnormalities of tumor suppressor gene SMARCB1 have been found in RMC. Reported symptoms were hematuria, pain, weight loss, respiratory distress, palpable mass, cough, and fever. Most patients present with metastases at diagnosis. There is no definite recommended treatment, and protocols are extrapolated from other malignancies, with nephrectomy and systemic therapies being most frequently used. Response to treatment and prognosis remain very poor. RMC is a rare and aggressive tumor. Definitive diagnosis requires histological assessment and the presence of sickle-cell hemoglobinopathies.
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13
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Imaging for Screening and Surveillance of Patients with Hereditary Forms of Renal Cell Carcinoma. Curr Urol Rep 2018; 19:82. [DOI: 10.1007/s11934-018-0829-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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14
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Gupta S, Kang HC, Ganeshan D, Morani A, Gautam R, Choyke PL, Kundra V. The ABCs of BHD: An In-Depth Review of Birt-Hogg-Dubé Syndrome. AJR Am J Roentgenol 2017; 209:1291-1296. [PMID: 28981362 DOI: 10.2214/ajr.17.18071] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Birt-Hogg-Dubé (BHD) syndrome is an autosomal dominant inherited syndrome involving multiple organs. In young patients, renal neoplasms that are multiple, bilateral, or both, such as oncocytomas, chromophobe renal cell carcinoma (RCC), hybrid chromophobe RCC-oncocytomas, clear cell RCC, and papillary RCC, can suggest BHD syndrome. Extrarenal findings, including dermal lesions, pulmonary cysts, and spontaneous pneumothoraces, also aid in diagnosis. CONCLUSION Radiologists may be one of the first medical specialists to suggest the diagnosis of BHD syndrome. Knowledge of pathogenesis and management, including the importance of the types of renal neoplasms in a given patient, is needed to properly recognize this rare condition.
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Affiliation(s)
- Shiva Gupta
- 1 Department of Diagnostic Radiology, University of Texas MD Anderson Cancer, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030
| | - Hyunseon C Kang
- 1 Department of Diagnostic Radiology, University of Texas MD Anderson Cancer, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030
| | - Dhakshinamoorthy Ganeshan
- 1 Department of Diagnostic Radiology, University of Texas MD Anderson Cancer, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030
| | - Ajaykumar Morani
- 1 Department of Diagnostic Radiology, University of Texas MD Anderson Cancer, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030
| | - Rabindra Gautam
- 2 Harris Technical Services Corporation, National Institutes of Health/National Cancer Institute, Bethesda, MD
| | - Peter L Choyke
- 3 Center for Cancer Research, National Institutes of Health/National Cancer Institute, Bethesda, MD
| | - Vikas Kundra
- 1 Department of Diagnostic Radiology, University of Texas MD Anderson Cancer, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030
- 4 Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
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15
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Liu X, Mao YH, He XM, Zhang YJ, Sun Y. Analysis on Inpatient Health Expenditures of Renal Cell Carcinoma in a Grade-A Tertiary Hospital in Beijing. Chin Med J (Engl) 2017; 130:2447-2452. [PMID: 29052566 PMCID: PMC5660998 DOI: 10.4103/0366-6999.216412] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Renal cell carcinoma (RCC) is the most common type of malignant renal tumors with a growing incidence in the recent years. This study aimed to investigate the influencing factors and variation trend of hospitalization expenditures among RCC patients in a single-centered hospital in Beijing during 5 consecutive years and to find the major cost items and fluctuation tendency of inpatient medical expenditures. METHODS The information of medical expenditures among RCC patients in a Grade-A tertiary hospital during the years 2012-2016 was investigated to find the main cost items and changes affecting the medical cost structure. Gray correlation method was adopted in quantitative analysis to analyze the composition of medical expenditures, and the variation of hospitalization expense structure during the five years was studied by analyzing the degree of structural variation. RESULTS The cost item constitution of the hospitalization expenditures among RCC patients was relatively stable in the sample hospital during the past five years. To be specific, drug costs accounted for the largest proportion of medical expenditures each year, with the highest of 37.81% in 2012, and showed a slowly declining tendency in the coming years. The cost item with the highest correlation degree was drug costs, with the value of 1.0000; followed by the costs of surgeries, 0.8423. Furthermore, drug costs shared the largest proportion (40.95%) of structural variation, followed by the costs of surgeries (18.35%). CONCLUSIONS Drug costs are the major influencing factors of the hospitalization expenditures among RCC patients. Thus, reasonable control on excessive drugs as well as the standardization of the diagnosis and treatment behaviors is conducive in reducing medical expenditures as well as easing patients' economic burdens. Besides, the positive growth on surgery costs suggests that the labor value of medical staffs has been gradually recognized.
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Affiliation(s)
- Xin Liu
- Department of Nephrology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Yong-Hui Mao
- Department of Nephrology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Xue-Mei He
- Clinical Pharmacology Center, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Yan-Jing Zhang
- Department of Nephrology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Ying Sun
- Department of Nephrology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
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16
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Cox VL, Bhosale P, Varadhachary GR, Wagner-Bartak N, Glitza IC, Gold KA, Atkins JT, Soliman PT, Hong DS, Qayyum A. Cancer Genomics and Important Oncologic Mutations: A Contemporary Guide for Body Imagers. Radiology 2017; 283:314-340. [DOI: 10.1148/radiol.2017152224] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Veronica L. Cox
- From the Department of Radiology, Abdominal Imaging Section (V.L.C., P.B., N.W.B., A.Q.), Department of Gastrointestinal Medical Oncology (G.R.V.), Department of Melanoma Medical Oncology (I.C.G.), Department of Thoracic and Head & Neck Medical Oncology (K.A.G.), Department of Gynecologic Oncology (P.T.S.), Department of Investigational Cancer Therapeutics (J.T.A., D.S.H.), University of Texas MD
| | - Priya Bhosale
- From the Department of Radiology, Abdominal Imaging Section (V.L.C., P.B., N.W.B., A.Q.), Department of Gastrointestinal Medical Oncology (G.R.V.), Department of Melanoma Medical Oncology (I.C.G.), Department of Thoracic and Head & Neck Medical Oncology (K.A.G.), Department of Gynecologic Oncology (P.T.S.), Department of Investigational Cancer Therapeutics (J.T.A., D.S.H.), University of Texas MD
| | - Gauri R. Varadhachary
- From the Department of Radiology, Abdominal Imaging Section (V.L.C., P.B., N.W.B., A.Q.), Department of Gastrointestinal Medical Oncology (G.R.V.), Department of Melanoma Medical Oncology (I.C.G.), Department of Thoracic and Head & Neck Medical Oncology (K.A.G.), Department of Gynecologic Oncology (P.T.S.), Department of Investigational Cancer Therapeutics (J.T.A., D.S.H.), University of Texas MD
| | - Nicolaus Wagner-Bartak
- From the Department of Radiology, Abdominal Imaging Section (V.L.C., P.B., N.W.B., A.Q.), Department of Gastrointestinal Medical Oncology (G.R.V.), Department of Melanoma Medical Oncology (I.C.G.), Department of Thoracic and Head & Neck Medical Oncology (K.A.G.), Department of Gynecologic Oncology (P.T.S.), Department of Investigational Cancer Therapeutics (J.T.A., D.S.H.), University of Texas MD
| | - Isabella C. Glitza
- From the Department of Radiology, Abdominal Imaging Section (V.L.C., P.B., N.W.B., A.Q.), Department of Gastrointestinal Medical Oncology (G.R.V.), Department of Melanoma Medical Oncology (I.C.G.), Department of Thoracic and Head & Neck Medical Oncology (K.A.G.), Department of Gynecologic Oncology (P.T.S.), Department of Investigational Cancer Therapeutics (J.T.A., D.S.H.), University of Texas MD
| | - Kathryn A. Gold
- From the Department of Radiology, Abdominal Imaging Section (V.L.C., P.B., N.W.B., A.Q.), Department of Gastrointestinal Medical Oncology (G.R.V.), Department of Melanoma Medical Oncology (I.C.G.), Department of Thoracic and Head & Neck Medical Oncology (K.A.G.), Department of Gynecologic Oncology (P.T.S.), Department of Investigational Cancer Therapeutics (J.T.A., D.S.H.), University of Texas MD
| | - Johnique T. Atkins
- From the Department of Radiology, Abdominal Imaging Section (V.L.C., P.B., N.W.B., A.Q.), Department of Gastrointestinal Medical Oncology (G.R.V.), Department of Melanoma Medical Oncology (I.C.G.), Department of Thoracic and Head & Neck Medical Oncology (K.A.G.), Department of Gynecologic Oncology (P.T.S.), Department of Investigational Cancer Therapeutics (J.T.A., D.S.H.), University of Texas MD
| | - Pamela T. Soliman
- From the Department of Radiology, Abdominal Imaging Section (V.L.C., P.B., N.W.B., A.Q.), Department of Gastrointestinal Medical Oncology (G.R.V.), Department of Melanoma Medical Oncology (I.C.G.), Department of Thoracic and Head & Neck Medical Oncology (K.A.G.), Department of Gynecologic Oncology (P.T.S.), Department of Investigational Cancer Therapeutics (J.T.A., D.S.H.), University of Texas MD
| | - David S. Hong
- From the Department of Radiology, Abdominal Imaging Section (V.L.C., P.B., N.W.B., A.Q.), Department of Gastrointestinal Medical Oncology (G.R.V.), Department of Melanoma Medical Oncology (I.C.G.), Department of Thoracic and Head & Neck Medical Oncology (K.A.G.), Department of Gynecologic Oncology (P.T.S.), Department of Investigational Cancer Therapeutics (J.T.A., D.S.H.), University of Texas MD
| | - Aliya Qayyum
- From the Department of Radiology, Abdominal Imaging Section (V.L.C., P.B., N.W.B., A.Q.), Department of Gastrointestinal Medical Oncology (G.R.V.), Department of Melanoma Medical Oncology (I.C.G.), Department of Thoracic and Head & Neck Medical Oncology (K.A.G.), Department of Gynecologic Oncology (P.T.S.), Department of Investigational Cancer Therapeutics (J.T.A., D.S.H.), University of Texas MD
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17
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Corral de la Calle M, Encinas de la Iglesia J, Martín López M, Fernández Pérez G, Águeda del Bas D. The radiologist's role in the management of papillary renal cell carcinoma. RADIOLOGIA 2017. [DOI: 10.1016/j.rxeng.2017.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Corral de la Calle MÁ, Encinas de la Iglesia J, Martín López MR, Fernández Pérez GC, Águeda Del Bas DS. The radiologist's role in the management of papillary renal cell carcinoma. RADIOLOGIA 2017; 59:100-114. [PMID: 28160948 DOI: 10.1016/j.rx.2016.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 11/05/2016] [Accepted: 11/08/2016] [Indexed: 12/20/2022]
Abstract
Papillary carcinoma is the second most common renal cell carcinoma. It has a better prognosis than the more frequent clear cell carcinoma, although this does not hold true for advanced cases, because no specific treatment exists. It presents as a circumscribed peripheral tumor (small and homogeneously solid or larger and cystic/hemorrhagic) or as an infiltrating lesion that invades the veins, which has a worse prognosis. Due to their low vascular density, papillary renal cell carcinomas enhance less than other renal tumors, and this facilitates their characterization. On computed tomography, they might not enhance conclusively, and in these cases they are impossible to distinguish from hyperattenuating cysts. Contrast-enhanced ultrasonography and magnetic resonance imaging are more sensitive for detecting vascularization. Other characteristics include a specific vascular pattern, hypointensity on T2-weighted images, restricted water diffusion, and increased signal intensity in opposed phase images. We discuss the genetic, histologic, clinical, and radiological aspects of these tumors in which radiologists play a fundamental role in management.
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Affiliation(s)
| | | | - M R Martín López
- Servicio de Anatomía Patológica, Complejo Asistencial de Ávila, Ávila, España
| | - G C Fernández Pérez
- Servicio de Radiodiagnóstico, Hospital Universitario del Río Hortega, Valladolid, España
| | - D S Águeda Del Bas
- Servicio de Radiodiagnóstico, Complejo Asistencial de Ávila, Ávila, España
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19
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Gaur S, Turkbey B, Choyke P. Hereditary Renal Tumor Syndromes: Update on Diagnosis and Management. Semin Ultrasound CT MR 2016; 38:59-71. [PMID: 28237281 DOI: 10.1053/j.sult.2016.10.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hereditary renal cancers account for approximately 5%-8% of all renal tumors. Over the past 2 decades, a number of syndromes have been identified that predispose patients to early renal cancer development, representing all the major histologic types of tumor pathology. In this article, we describe the current knowledge concerning the cell type, known mechanism of tumor development, other manifestations of the syndrome, imaging findings, genetic screening, and imaging surveillance recommendations for each of the major syndromes associated with hereditary renal cancers.
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Affiliation(s)
- Sonia Gaur
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Baris Turkbey
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Peter Choyke
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD.
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20
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Abstract
Hereditary forms of kidney carcinoma account for 5-8% of all malignant kidney neoplasms. The renal tumors are often multiple and bilateral and occur at an earlier age. Each of the hereditary kidney carcinoma syndromes is associated with specific gene mutations as well as a specific histologic type of kidney carcinoma. The presence of associated extrarenal manifestations may suggest a hereditary kidney cancer syndrome. Radiology is most commonly used to screen and manage patients with hereditary kidney cancer syndromes. This manuscript reviews the clinical and imaging findings of well-defined inherited kidney cancer syndromes including von Hippel-Lindau disease, Birt-Hogg-Dubé syndrome, hereditary papillary renal carcinoma syndrome, hereditary leiomyomatosis and RCC syndrome, tuberous sclerosis complex, and Lynch syndrome.
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