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Abstract
RATIONALE About 8384 cases of solid pseudopapillary neoplasms (SPN) of pancreas have been published in English literature, from 1933 to 2018. This is a low-grade tumor that usually occurs in children but is rare in adults and, in exceptional cases, can show extrapancreatic localization. In this paper we present 2 unusual cases of SPNs, 1 with retroperitoneal location (case 1) and 1 that was firstly diagnosed as a G1 neuroendocrine tumor (NET) and showed hepatic metastases after 13 years (case 2). PATIENT CONCERNS No symptoms in first case. The tumor was incidentally diagnosed, during ultrasound examination. In the second case, the metastasis was observed during regular follow-up. DIAGNOSES The diagnosis was established based on the histological features and immunohistochemical profile that showed positivity for vimentin, nuclear β-catenin, cyclin D1, CD10, and SRY-related high-mobility group box 11 and negativity for maspin. INTERVENTIONS Surgical excision, in both cases. OUTCOMES No recurrences in first case, at 5 months after diagnosis. Hepatic metastases in the second case, at 13 years after diagnosis, with portal invasion after another 15 months. LESSONS Without a complex immunoprofile, SPN can be misdiagnosed as NET. SPN can be a low-grade tumor but long-time follow-up is mandatory to detect delayed metastases. A correct diagnosis is necessary for a proper therapeutic management.
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MESH Headings
- Adenocarcinoma, Papillary/immunology
- Adenocarcinoma, Papillary/pathology
- Adenocarcinoma, Papillary/physiopathology
- Adenocarcinoma, Papillary/therapy
- Adult
- Biomarkers, Tumor/analysis
- Cyclin D1/analysis
- Diagnosis, Differential
- Female
- Humans
- Immunohistochemistry
- Middle Aged
- Neoplasms, Cystic, Mucinous, and Serous/immunology
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Neoplasms, Cystic, Mucinous, and Serous/physiopathology
- Neoplasms, Cystic, Mucinous, and Serous/therapy
- Neprilysin/analysis
- Neuroendocrine Tumors/diagnosis
- Pancreas/pathology
- Pancreatectomy/adverse effects
- Pancreatectomy/methods
- Pancreatic Neoplasms/immunology
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/physiopathology
- Pancreatic Neoplasms/therapy
- Prognosis
- Treatment Outcome
- Vimentin/analysis
- beta Catenin/analysis
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Affiliation(s)
- Simona Gurzu
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology
- Department of Pathology, Clinical County Emergency Hospital
- Department of Pathology, Research Center (CCAMF)
| | - Tivadar Bara
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania
| | - Mihaela Sincu
- Department of Pathology, Clinical County Emergency Hospital
| | - Szilard Gabos
- Department of Pathology, Clinical County Emergency Hospital
| | | | - Tivadar Bara
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania
| | - Hanga Beres
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology
| | - Ioan Jung
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology
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Yamada R, Nishikawa K, Tanaka K, Tsuboi J. A Rare Form of Intraductal Papillary Mucinous Carcinoma. Intern Med 2019; 58:451-452. [PMID: 30210117 PMCID: PMC6395132 DOI: 10.2169/internalmedicine.1250-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
MESH Headings
- Adenocarcinoma, Mucinous/complications
- Adenocarcinoma, Mucinous/diagnostic imaging
- Adenocarcinoma, Mucinous/microbiology
- Adenocarcinoma, Mucinous/physiopathology
- Adenocarcinoma, Papillary/complications
- Adenocarcinoma, Papillary/diagnostic imaging
- Adenocarcinoma, Papillary/microbiology
- Adenocarcinoma, Papillary/physiopathology
- Aged
- Anti-Bacterial Agents/therapeutic use
- Carcinoma, Pancreatic Ductal/complications
- Carcinoma, Pancreatic Ductal/diagnostic imaging
- Carcinoma, Pancreatic Ductal/microbiology
- Carcinoma, Pancreatic Ductal/physiopathology
- Female
- Humans
- Infections/drug therapy
- Rare Diseases/microbiology
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Affiliation(s)
- Reiko Yamada
- Department of Gastroenterology and Hepatology, Mie University Hospital, Japan
| | | | | | - Junya Tsuboi
- Department of Endoscopy, Mie University Hospital, Japan
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Hirsch D, Levy S, Tsvetov G, Weinstein R, Lifshitz A, Singer J, Shraga-Slutzky I, Grozinski-Glasberg S, Shimon I, Benbassat C. Impact of pregnancy on outcome and prognosis of survivors of papillary thyroid cancer. Thyroid 2010; 20:1179-85. [PMID: 20860423 DOI: 10.1089/thy.2010.0081] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Papillary thyroid cancer (PTC) commonly affects women of child-bearing age. During normal pregnancy, several factors may have a stimulatory effect on normal and nodular thyroid growth. The aim of the study was to determine whether pregnancy in thyroid-cancer survivors poses a risk of progression or recurrence of the disease. METHODS The files of 63 consecutive women who were followed at the Endocrine Institute for PTC in 1992-2009 and had given birth at least once after receiving treatment were reviewed for clinical, biochemical, and imaging data. Thyroglobulin levels and neck ultrasound findings were compared before and after pregnancy. Demographic and disease-related characteristics and levels of thyroid-stimulating hormone (TSH) during pregnancy were correlated with disease persistence before conception and disease progression during pregnancy using Pearson's analysis. RESULTS Mean time to the first delivery after completion of thyroid-cancer treatment was 5.08 ± 4.39 years; mean duration of follow up after the first delivery was 4.84 ± 3.80 years. Twenty-three women had more than one pregnancy, for a total of 90 births. Six women had evidence of thyroid cancer progression during the first pregnancy; one of them also showed disease progression during a second pregnancy. Another two patients had evidence of disease progression only during their second pregnancy. Mean TSH level during pregnancy was 2.65 ± 4.14 mIU/L. There was no correlation of disease progression during pregnancy with pathological staging, interval from diagnosis to pregnancy, TSH level during pregnancy, or thyroglobulin level before conception. There was a positive correlation of cancer progression with persistence of thyroid cancer before pregnancy and before total I-131 dose was administered. CONCLUSIONS Pregnancy does not cause thyroid cancer recurrence in PTC survivors who have no structural or biochemical evidence of disease persistence at the time of conception. However, in the presence of such evidence, disease progression may occur during pregnancy, yet not necessarily as a consequence of pregnancy. The finding that a nonsuppressed TSH level during pregnancy does not stimulate disease progression suggests that it may be an acceptable therapeutic goal in this setting.
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Affiliation(s)
- Dania Hirsch
- Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
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Nakanuma Y, Kitagawa S, Itazu K, Sato Y, Zen Y. [Histopathology of bile duct carcinoma and clinical symptoms]. Nihon Rinsho 2006; 64 Suppl 1:379-83. [PMID: 16457287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- Yasuni Nakanuma
- Department of Human Pathology, Kanazawa University Graduate School of Medicine
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Ueshima Y, Kurioka H, Yamada R, Takumi C, Hiraoka N, Ono S. [Stromal bone formation by lung adenocarcinoma]. Nihon Kokyuki Gakkai Zasshi 2005; 43:523-6. [PMID: 16218421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
We report a case of lung adenocarcinoma with stromal bone formation. A 73-year-old woman was incidentally found to have a coin lesion in the left lower lung field on a chest roentgenogram and computed tomography showed a nodular lesion containing a few coarse high density areas in the left lower lobe. Since transbronchial cytology revealed adenocarcinoma, left lower lobectomy was performed. Histologically, the tumor was a papillary-tubular adenocarcinoma, and fragments of osseous tissue were found within abundant fibrous stroma. Bone formation in primary lung adenocarcinoma is a very rare condition, and only 7 other cases have been reported in the literature.
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Affiliation(s)
- Yasuo Ueshima
- Department of Surgery, Kyoto First Red Cross Hospital
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Kamisawa T, Egawa N, Nakajima H, Sakaki N, Tsuruta K, Okamoto A. Clinical significance of the accessory pancreatic duct. Hepatogastroenterology 2003; 50:2196-8. [PMID: 14696497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND/AIMS The accessory pancreatic duct is the smaller and less constant pancreatic duct in comparison with the main pancreatic duct. We investigated the patency of the accessory pancreatic duct and its role in pancreatic pathophysiology. METHODOLOGY Dye-injection endoscopic retrograde pancreatography was performed in 411 patients. In patients in whom the main pancreatic duct could be selectively cannulated, contrast medium with indigo carmine was injected through the catheter. Excretion of the dye from the minor duodenal papilla was observed endoscopically. RESULTS Patency of the accessory pancreatic duct was 43% of the 291 control cases. In the 46 patients with acute pancreatitis, 8 (17%) had a patent accessory pancreatic duct. The difference in patency between this group and the normal group was significant (p < 0.01). Especially, patency of the accessory pancreatic duct was only 8% of the 13 patients with acute biliary pancreatitis. In the patients with pancreaticobiliary maljunction, biliary carcinoma occurred in 72% of patients with a nonpatent accessory pancreatic duct, but in contrast, it occurred only in 30% of those with a patent accessory pancreatic duct. This difference was significant (p < 0.05). Lower amylase level in the bile of patients with pancreaticobiliary maljunction with a patent accessory pancreatic duct was frequently observed than those with a nonpatent accessory pancreatic duct. CONCLUSIONS A patent accessory pancreatic duct may prevent acute pancreatitis by lowering the pressure in the main pancreatic duct. In cases of pancreaticobiliary maljunction with a patent accessory pancreatic duct, the incidence of carcinogenesis of the bile duct might be lower, as the reflux of the pancreatic juice to the bile duct might be reduced by the flow of the pancreatic juice into the duodenum through the accessory pancreatic duct.
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Affiliation(s)
- Terumi Kamisawa
- Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, 113-8677 Tokyo, Japan.
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Shimada H. [Development in the basical and clinical research of pancreatic optic tumor focusing on intraductal papillary mucinous tumor (IPMT)]. Nihon Geka Gakkai Zasshi 2003; 104:437-8. [PMID: 12854488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- Hiroshi Shimada
- Department of Surgery II, Yokohama City University School of Medicine, Yokohama, Japan
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MESH Headings
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/pathology
- Adenocarcinoma, Mucinous/physiopathology
- Adenocarcinoma, Mucinous/therapy
- Adenocarcinoma, Papillary/epidemiology
- Adenocarcinoma, Papillary/pathology
- Adenocarcinoma, Papillary/physiopathology
- Adenocarcinoma, Papillary/therapy
- Carcinoma, Pancreatic Ductal/epidemiology
- Carcinoma, Pancreatic Ductal/pathology
- Carcinoma, Pancreatic Ductal/physiopathology
- Carcinoma, Pancreatic Ductal/therapy
- Humans
- Incidence
- Pancreatic Neoplasms/epidemiology
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/physiopathology
- Pancreatic Neoplasms/therapy
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Affiliation(s)
- N Volkan Adsay
- Department of Pathology, Harper University Hospital and Wayne State University School of Medicine, Detroit, MI 48201, USA
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Sugiura H, Kondo S, Islam HK, Ito K, Ono K, Morikawa T, Okushiba S, Katoh H. Clinicopathologic features and outcomes of intraductal papillary-mucinous tumors of the pancreas. Hepatogastroenterology 2002; 49:263-7. [PMID: 11941971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND/AIMS The authors reviewed their experience with resected IPMT (intraductal papillary-mucinous tumor) of the pancreas to clarify the characteristics and prognosis of this neoplasm. METHODOLOGY Between 1983 and 1998, 30 consecutive patients with IPMT underwent operations at our institution. Their clinicopathological features and postoperative long-term outcomes were analyzed retrospectively. RESULTS There were 22 males and 8 females, with a mean age of 64 years. Operations performed were duodenum-preserving pancreatic head resection in 12 patients, distal pancreatectomy in 8, segmental pancreatectomy in 6, conventional pancreaticoduodenectomy in 4. Malignancy was found in 10 of 30 (33%). Factors significantly associated with malignancy were tumor size or presence in main pancreatic duct. In 30 resected patients after a mean follow-up of 60 months, tumor recurrence had occurred in 2 cases of invasive carcinoma that infiltrated into the extrapancreatic organ. The overall actuarial 5-year and 10-year survival was 83% and 62%, respectively. CONCLUSIONS IPMT has a favorable prognosis after adequate resection. Despite slow growth, IPMT has an obvious malignant potential and a poor prognosis when invasive carcinoma has developed. Early recognition and pancreatectomy is the mainstay of treatment for IPMT.
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Affiliation(s)
- Hiroshi Sugiura
- Second Department of Surgery, Hokkaido University Hospital, N-14, W-5, Sapporo, 060-8648, Japan.
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Abstract
OBJECTIVE More than 80% of human ovarian cancers express LHRH and its receptor. The proliferation of human ovarian cancer cell lines is reduced by both LHRH agonists and antagonists. This study was designed to further clarify the possible biological function of this LHRH system. DESIGN As LHRH agonists and antagonists uniformly reduce proliferation of human ovarian cancer in a dose-dependent way, the effect of low concentrations of authentic LHRH was studied. In addition, longer periods of treatment (up to 9 days) were analyzed. To assess the physiological role of LHRH produced by ovarian cancer cells it was neutralized by adequate concentrations of a specific LHRH antiserum. METHODS Human ovarian cancer cells EFO-21 and EFO-27, which express LHRH and its receptor, were incubated for 1-9 days with increasing concentrations (1pmol/l to 10 micromol/l) of authentic LHRH or with concentrations of LHRH antiserum capable of neutralizing at least 1nmol/l LHRH. Proliferation was assessed by counting cells. RESULTS AND CONCLUSIONS Authentic LHRH reduced time- and dose-dependently proliferation (by maximally mean+/-s.e.m. 32.7 +/- 4.4%, Newman-Keuls, P < 0.001) of both ovarian cancer cell lines. At very low concentrations (1pmol/l) a marginal reduction of proliferation or no effect was observed. A mitogenic effect of authentic LHRH was never detected. Treatment of ovarian cancer cell cultures with antiserum to LHRH significantly increased (up to mean+/-s.e.m. 121.0 +/- 2.8% of controls, Newman-Keuls P <0.001) proliferation of EFO-21 and EFO-27 cells. These findings suggest that LHRH produced by human ovarian cancer cells might act as a negative autocrine regulator of proliferation.
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Affiliation(s)
- G Emons
- Departments of Gynecology and Obstetrics, Georg-August University, Robert-Koch-Street 40, D-37075, Göttingen, Germany
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Mano T, Shinohara R, Iwase K, Kotake M, Hamada M, Uchimuro K, Hayakawa N, Hayashi R, Nakai A, Ishizuki Y, Nagasaka A. Changes in free radical scavengers and lipid peroxide in thyroid glands of various thyroid disorders. Horm Metab Res 1997; 29:351-4. [PMID: 9288568 DOI: 10.1055/s-2007-979052] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To clarify whether the changes of free radicals and its scavengers are induced by thyroid disorders, we measured levels of free radical scavengers and checked O2 radical generating systems in the human thyroid gland. Thyroid specimens from patients with Graves' disease, follicular adenoma, and papillary and follicular carcinomas contained significantly higher concentrations of xanthine oxidase (XOD) and gluthathione peroxidase (GSH-PX), compared to those in the normal thyroid tissue. Catalase concentration was significantly lower in thyroid specimens from patients with Graves' disease and significantly lower in thyroid specimens from patients with follicular adenoma, compared to those in the normal thyroid tissue. Cu/Zn superoxide dismutase (Cu/Zn SOD) concentration was significantly lower in the specimens from follicular adenoma and papillary carcinoma and Mn SOD concentration was significantly higher in the specimens from papillary carcinoma than those in the normal thyroid tissue. The lipid peroxide concentration, expressed as malondialdehyde (MDA) concentration, was significantly higher in the specimens from papillary carcinoma than those in the normal thyroid tissue. These findings suggest that the levels of free radicals are increased and are scavenged and catalyzed in the thyroid of Graves' disease, whereas free radicals and lipid peroxide are not completely scavenged in papillary carcinoma tissues, suggesting that these substances affect some role in cell function of thyroid tumors.
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Affiliation(s)
- T Mano
- Department of Internal Medicine, Fujita Health University School of Medicine, Aichi, Japan
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Affiliation(s)
- D C MacGillivray
- Department of Surgery, University of Connecticut Health Center, Farmington 06030, USA
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Clarke DE, Green RJ, Mark JB, Robbins RC, Raffin TA. Upper airway obstruction caused by low-grade tracheal papillary adenocarcinoma: an usual flow-volume loop pattern. J Thorac Cardiovasc Surg 1996; 111:1286-8. [PMID: 8642833 DOI: 10.1016/s0022-5223(96)70234-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- D E Clarke
- Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Calif, USA
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Fujieda S, Noda I, Saito H, Hoshino T, Yagita M. Heat shock enhances the susceptibility of tumor cells to lysis by lymphokine-activated killer cells. Arch Otolaryngol Head Neck Surg 1995; 121:1009-14. [PMID: 7646852 DOI: 10.1001/archotol.1995.01890090049010] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To determine whether heat-treated thyroid cancer cells augment the susceptibility of target cells to lysis by autologous lymphokine-activated killer cells. DESIGN Peripheral blood lymphocytes from patients with thyroid cancer were incubated with recombinant interleukin 2 (100 U/mL) for 7 days, and thyroid cancer cells obtained from surgical specimens were heated at 44 degrees C for 20 minutes and incubated at 37 degrees C for 18 hours before performing the radioactive chromium Cr 51 release assay. RESULTS The susceptibility of heat-treated thyroid cancer cells to lysis by autologous and allogeneic lymphokine-activated killer cells was significantly greater than that of untreated tumor cells. The mechanism of enhanced susceptibility was unclear. However, the effect depended on de novo protein synthesis, because inhibition of RNA synthesis by dactinomycin completely abolished the heat-enhanced susceptibility of tumor cells. CONCLUSION Immunotherapy combined with hyperthermia may be useful in management of thyroid cancer.
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Affiliation(s)
- S Fujieda
- Department of Oto-Rhino-Laryngology, Fukui, Medical School, Japan
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Abstract
Sarcoid reactions have been described in association with lymphomas and rarely with other solid tumors. We describe a patient with renal papillary adenocarcinoma and prominent sarcoid-like granulomatous infiltration of the ipsilateral and most likely the contralateral kidney. There was no evidence of extrarenal granulomas. This is the first description of impairment in renal function in a patient with renal carcinoma and with sarcoid reaction to this tumor isolated in the kidney.
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