Mixed epithelial stromal tumor of the kidney

Tumor-to-Tumor Metastasis of Lung Cancer to Kidney Cancer: A Review of the Literature and Our Experience

Tumor-to-tumor metastasis (TTM) is a rare phenomenon documented in patients with multiple primary cancers. This condition is defined as a metastasis between two true primary tumors. The most frequently reported recipient tumor is renal cell carcinoma (RCC), and the lung carcinomas are the most common metastatic tumor donors. Therefore, this paper attempts to address the current gap in knowledge about this rare phenomenon. The first part of this review outlines the recently proposed models and mechanisms involved in the TTM process. The second part then summarizes and analyzes previous case reports in the literature. We also present our experience with the case of lung cancer that metastasized into RCC. Given the sporadic incidence of TTM, no specific management guidelines exist. Therefore, considering TTM in patients with multiple primary tumors is important as it could potentially modify the oncological management offered.

Mixed epithelial and stromal tumor of the kidney treated with minimally invasive surgery

Mixed epithelial and stromal tumor of the kidney (MESTK) is a rare kidney tumor that tends to occur in middle-aged and older women and is characterized by a distinctive histological appearance. Most of them were incidentally detected. A 26-year-old female patient was referred to in our clinic due to intermittent left lower back pain for 2 months and left renal mass. Abdominal computed tomography showed a cystic enhanced heterogenic left renal mass about 5 cm in the largest diameter was extending from the renal pelvis to the ureter and causing gross hydronephrosis of the left kidney. The mass treated with transperitoneal laparoscopic nephroureterectomy and bladder cuff resection. Histopathological evaluation revealed MESTK. In our patient, MESTK successfully and without any complication be treated by minimally invasive surgery. We believe that the fact that the tumor can mimic the urothelial-cell carcinoma of the kidney in radiological appearance, as seen in our case, should be taken into consideration.

Metastasis in mixed epithelial stromal tumour of the kidney: a rare presentation

Mixed epithelial stromal tumour of the kidney (MESTK) is a rare genitourinary tract tumour. MESTK is typically seen in perimenopausal women and rarely reported in men and children. MESTK has been included in the WHO renal tumour classification since 2004. Here, we present a case of 50-year-old female patient who underwent left radical nephrectomy for left renal mass. Postoperative positron emission tomography (PET) scan also showed nodal metastasis, for which, she was started on chemotherapy.

Mixed epithelial and stromal tumor of the kidney: a rare case report and review of the literatures

Mixed epithelial and stromal tumor of the kidney (MESTK) is a rare complex renal neoplasm composed of a mixture of cystic and solid components. Until date only few cases of MESTK have been reported. We present here a rare case of MESTK that was diagnosed in a 56-year-old female. The patients were referred to our hospital due to a mass on the right kidney identified incidentally in a routine physical examination. A pre-operative diagnosis of cystic renal cell carcinoma was made and a right radical nephrectomy was carried out. Macroscopically, a cystic tumor was noticed in the upper portion of the right kidney. Various-sized cysts accompanied by multiple cysts and few solid areas were observed. Immunohistochemically, various epithelial markers as well as stromal markers were identified. Taken together with all the immunohistochemical results and morphological pattern of the tumor, a diagnosis of MESTK was made. MESTK is relatively rare and generally benign. However, it is difficult to distinguish between benign or malignant tumors according to the current radiological method. Therefore a complete resection of the tumor by partial or radical nephrectomy is suggested.

Enucleation/partial nephrectomy for large mixed epithelial stromal tumor and herniating into the pelvicalyceal system

OBJECTIVES

Mixed Epithelial and Stromal Tumor of the kidney is an adult renal neoplasm. It is mostly benign in nature. Typically it is composed of a mixture of epithelial and mesenchymal components. We hereby report on the feasibility of performing partial nephrectomy/enucleation for Huge Mixed Epithelial Stromal Tumor of the kidney without sacrificing the involved renal unit even in the tumors herniating into the collecting system.

METHODS

Two female patients on long term hormonal therapy developed large enhancing multiloculated and septated renal masses. Kidney mass size was 18.5 cms in one patient and 11.5 in the second. In one patient, the mass was herniating into the collecting system. Both patients had enucleation/partial nephrectomy.

RESULTS

Enucleation and partial nephrectomy were successfully performed in both patients. In the patient with the mass herniating into the collecting system, the horns of the mass herniating into the collecting system were easily enucleated with repair of the collecting system and salvage of the involved renal unit. Post op pathology revealed MEST in both patients. There were no intraoperative or postoperative complications.

CONCLUSIONS

Enucleation and partial nephrectomy for huge MEST is feasible. Mixed Epithelial Stromal Tumor herniating into the pelvicalyceal system may not warrant nephroureterectomy as previously reported.