Early Occurrence of Two Distinct Histological Types of Renal Cell Carcinoma in End-Stage Renal Disease Patient on Haemodialysis
Abstract
Background: The occurrence of renal cell carcinoma is a well-known complication in end-stage renal disease on haemodialysis. Various histological types of renal cell carcinomas are observed in these patients and varies with the duration of haemodialysis. Though the synchronous association of two renal cell carcinomas in the patients are known, the existence of such dual renal tumours in the patient on dialysis is extremely rare and unheard in the English literature. Moreover, tubulocystic renal cell carcinoma is rarely reported in this setting. Case report and Discussion: We describe an unusual early synchronous occurrence of two tumours with distinct histology i.e. Papillary renal cell carcinoma (PRCC, type I) and Tubulocystic renal cell carcinoma (TC-RCC) in a patient with end-stage renal disease on haemodialysis for a duration less than a year. Though exact etiological factors peculiar to the occurrence of these tumours are not known, increased oxidative stress occurring in end-stage renal disease patient on haemodialysis might play an important role in carcinogenesis. Conclusion: Renal cell carcinoma with more than one histological type may occur exceedingly early without any symptoms in these patients. Radiologists and urologists should be aware of it for early diagnosis and prompt treatment. Pathologists should also be more cautious while grossing and pick the sub-centimetric primary or secondary tumours that may have an impact on patient survival.References
Tsuzuki T, Iwata H, Murase Y, Takahara T, Ohashi A. Renal tumors in end-stage renal disease: A comprehensive review. Int J Urol. 2018;25(9):780-86.
Kojima Y, Takahara S, Miyake O, Nonomura N, Morimoto A, Mori H. Renal cell carcinoma in dialysis patients: a single center experience. Int J Urol. 2006;13(8):1045-48.
Toyokuni S. The origin and future of oxidative stress pathology: From the recognition of carcinogenesis as an iron addiction with ferroptosis-resistance to non-thermal plasma therapy. Pathol Int. 2016;66(5):245–59.
Nouh MAAM, Kuroda N, Yamashita M, Hayashida Y, Yano T, Minakuchi J, et al. Renal cell carcinoma in patients with end-stage renal disease: relationship between histological type and duration of dialysis. BJU Int. 2010 Mar;105(5):620–27.
Hori Y, Oda Y, Kiyoshima K, Yamada Y, Nakashima Y, Naito S, et al. Oxidative stress and DNA hypermethylation status in renal cell carcinoma arising in patients on dialysis. J Pathol. 2007;212(2):218-26.
Sassa N, Hattori R, Tsuzuki T, Watarai Y, Fukatsu A, Katsuno S, et al. Renal cell carcinomas in haemodialysis patients: does haemodialysis duration influence pathological cell types and prognosis? Nephrol Dial Transplant. 2011;26(5):1677–82.
Kong MX, Hale C, Subietas-Mayol A, Lee P, Cassai ND, McRae G, et al. Bilateral Tubulocystic Renal Cell Carcinomas in Diabetic End-Stage Renal Disease: First Case Report with Cytogenetic and Ultrastructural Studies. Rare Tumors. 2013 Dec; 5(4)
Goyal R, Parwani AV, Gellert L, Hameed O, Giannico GA. A Collision Tumor of Papillary Renal Cell Carcinoma and Oncocytoma: Case Report and Literature Review. Am J Clin Pathol. 2015;144(5):811–6.
Burch-Smith R, Tannir NM, Resetkova E, Tamboli P, Rao P. Collision tumor of the kidney composed of clear cell carcinoma and collecting duct carcinoma: report of a case with unusual morphology and clinical follow-up. Chin J Cancer. 2014;33(7):351–5.
Moch H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours. Eur Urol. 2016;70(1):93–105.
Brennan C, Srigley JR, Whelan C, Cooper J, Delahunt B. Type 2 and Clear Cell Papillary Renal Cell Carcinoma, and Tubulocystic Carcinoma: A Unifying Concept. Anticancer Res. 2010;30(2):641–4.
Sarungbam J, Mehra R, Tomlins SA, Smith SC, Jayakumaran G, Al-Ahmadie H, et al. Tubulocystic renal cell carcinoma: a distinct clinicopathologic entity with a characteristic genomic profile. Mod Pathol. 2019;32(5):701–9.
Tran T, Jones CL, Williamson SR, Eble JN, Grignon DJ, Zhang S, et al. Tubulocystic renal cell carcinoma is an entity that is immunohistochemically and genetically distinct from papillary renal cell carcinoma. Histopathology. 2016;68(6):850–7.
Alaghehbandan R, Perez Montiel D, Luis AS, Hes O. Molecular Genetics of Renal Cell Tumors: A Practical Diagnostic Approach. Cancers (Basel). 2019 Dec 30;12(1):85.
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