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Chen H, Li Y, Zeng Q, Wu G. Renal primitive neuroectodermal tumor: A rare case with a good prognosis. Front Surg 2023; 10:1180107. [PMID: 37151856 PMCID: PMC10154518 DOI: 10.3389/fsurg.2023.1180107] [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: 03/05/2023] [Accepted: 03/24/2023] [Indexed: 05/09/2023] Open
Abstract
Background Renal primitive neuroectodermal tumor (rPNET) has the characteristics of a difficult preoperative diagnosis, a high degree of malignancy, easy early metastasis or postoperative recurrence, a poor prognosis, and so on. However, rPNET that has no metastasis before surgery can have a good survival prognosis only after radical surgical resection. Methods We report the case of a 14-year-old male patient with a renal tumor who underwent open radical left nephrectomy without radiotherapy or chemotherapy before or after surgery, as confirmed by postoperative pathological results. The prognosis was followed up by a regular review of the chest and whole abdomen on CT, hematuria analysis, renal function, and electrolytes according to the guidelines for renal cancer. Results Postoperative pathological results confirmed rPNET; no adjuvant radiotherapy or chemotherapy were performed after surgery; no tumor recurrence or metastasis were observed during the follow-up of nearly 5 years. Conclusions Despite the high degree of rPNET malignancy, patients without metastases before surgery can still obtain a good survival prognosis through timely radical surgery.
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Mao W, Xu J, Lu H, Wang Y, Zhang L, Chen M. A rare case report of renal ewing sarcoma/primitive neuroectodermal tumor with ACTH production. BMC Urol 2022; 22:103. [PMID: 35821028 PMCID: PMC9277804 DOI: 10.1186/s12894-022-01055-y] [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: 12/07/2020] [Accepted: 07/06/2022] [Indexed: 01/10/2023] Open
Abstract
Background Ewing sarcoma/primitive neuroectodermal tumor (PNET) of the renal is extremely rare. The common cause of ectopic ACTH syndrome is pulmonary neuroendocrine tumors, such as small cell carcinomas and carcinoid tumors. Here, we present an unusual case of ectopic ACTH syndrome and hypothyroidism caused by Ewing sarcoma/PNET of the right kidney. Case presentation A 19-year-old girl presented with a history of right lumbar pain and discomfort for 2 months, aggravated for 2 days. Abdominal contrast-enhanced computed tomography and computed tomography angiography showed an upper pole occupancy of the right kidney occupancy with subepithelial hemorrhage. Preoperative hormone levels including plasma total cortisol (PTC), adrenocorticotrophic hormone (ACTH) and thyroid hormone measurements were abnormal, indicating that the patient had Cushing syndrome and hypothyroidism. The patient underwent right radical nephrectomy. Histopathological analysis revealed a renal small round blue cell tumor (consistent with a primitive neuroectodermal tumor), with positive immunohistochemistry for CD99 and Ki67 (about 10%) and molecular pathology for EWSR1 gene fusions. PTC, ACTH and thyroid hormone returned to normal after surgery. Conclusions We report a rare ectopic ACTH syndrome and hypothyroidism due to renal Ewing sarcoma/PNET. The clinical manifestation of renal Ewing sarcoma/PNET is non-specific and the diagnosis relies on pathological morphology, immunohistochemistry and fusion gene detection. At present, surgery combined with radiotherapy and chemotherapy is used in the treatment, but the prognosis is still not optimistic.
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Affiliation(s)
- Weipu Mao
- Department of Urology, People's Hospital of Putuo District, No.1291, Jiangning Road, Putuo District, Shanghai, 200060, China.,Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, 210009, China.,Department of Urology, Nanjing Lishui District People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, 211200, China
| | - Jiajia Xu
- Department of Pathology, Affiliated Zhongda Hospital of Southeast University, No. 87 Dingjiaqiao, Hunan Road, Gulou District, Nanjing, 210009, China
| | - Haowen Lu
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, 210009, China
| | - Yali Wang
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, 210009, China
| | - Lihua Zhang
- Department of Pathology, Affiliated Zhongda Hospital of Southeast University, No. 87 Dingjiaqiao, Hunan Road, Gulou District, Nanjing, 210009, China.
| | - Ming Chen
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, 210009, China. .,Department of Urology, Nanjing Lishui District People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, 211200, China.
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Hamidi N. Editorial Comment to Renal primitive neuroectodermal tumor with elevated plasma adrenocorticotropic hormone levels: A case report. IJU Case Rep 2019; 2:131-132. [PMID: 32743392 PMCID: PMC7292098 DOI: 10.1002/iju5.12063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Nurullah Hamidi
- Department of UrologyDr. Abdurrahman Yurtaslan Ankara Oncology Training and Research HospitalAnkaraTurkey
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Shimizu N, Hasumi M, Hamano T, Iijima M, Yoshioka T, Yamazaki Y, Sasano H. Renal primitive neuroectodermal tumor with elevated plasma adrenocorticotropic hormone levels: A case report. IJU Case Rep 2019; 2:128-131. [PMID: 32743391 PMCID: PMC7292057 DOI: 10.1002/iju5.12057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 02/15/2019] [Indexed: 11/15/2022] Open
Abstract
Introduction Primitive neuroectodermal tumors are small round‐cell tumors – Ewing sarcoma family, frequently occurring in the extremities, but rarely in the kidney. Case presentation A 58‐year‐old woman presented with whole‐body edema and weakness of lower limb muscles. Computed tomography revealed a left renal tumor, and the plasma adrenocorticotropic hormone level was elevated. The tumor was surgically removed without complications, her plasma adrenocorticotropic hormone reverted to normal levels, and symptoms disappeared after surgery. Histopathological examination revealed a primitive neuroectodermal tumor arising in her kidney. The patient was alive without metastasis 3 years after the surgery. Conclusion We report the first case of renal primitive neuroectodermal tumor accompanying elevated plasma adrenocorticotropic hormone levels which are thought to be produced and secreted in an ectopic fashion.
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Affiliation(s)
- Nobuaki Shimizu
- Department of Urology Gunma Prefectural Cancer Center Ota Gunma Japan
| | - Masaru Hasumi
- Department of Urology Gunma Prefectural Cancer Center Ota Gunma Japan
| | - Tatsuya Hamano
- Department of Urology Gunma Prefectural Cancer Center Ota Gunma Japan.,Department of Urology Chichibu Municipal Hospital Chichibu Saitama Japan
| | - Misa Iijima
- Department of Pathology Gunma Prefectural Cancer Center Ota Gunma Japan
| | - Takako Yoshioka
- Department of Pathology National Center for Child Health and Development Setagaya-ku Tokyo Japan
| | - Yuto Yamazaki
- Department of Pathology Tohoku University School of Medicine Sendai Miyagi Japan
| | - Hironobu Sasano
- Department of Pathology Tohoku University School of Medicine Sendai Miyagi Japan
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