TY - JOUR
T1 - Multiple Discordant Histology after Nephrectomy
T2 - Descriptive Analysis and Outcomes
AU - Harlow, Brittani L.
AU - Klaassen, Zachary
AU - Holzman, Sarah
AU - Reinstatler, Lael
AU - Franken, Alicia A.
AU - Kavuri, Sravan K.
AU - Terris, Martha K.
AU - Master, Viraj A.
AU - Moses, Kelvin A.
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Background While RCC is the most common primary renal neoplasm, few cases of ipsilateral renal lesions of different RCC histologic subtypes have been described. The objective of this study was to evaluate our experience with synchronous, histologically unique, primary renal neoplasms within the same kidney. Patients and Methods We retrospectively analyzed 2 institutional nephrectomy databases from 2000 to 2013. The study cohort comprised 15 patients with multiple, discordant renal histology after partial or radical nephrectomy. Demographic data, immunohistochemical analysis, and clinical course were assessed and analyzed. Results Eight patients (53%) were black, 10 (60%) were male, and 5 (36%) were tobacco users. Median follow-up time was 13 months (range, 1-62 months), and 9 patients (56%) underwent radical nephrectomy. Among 36 tumors, the median tumor size was 2.3 cm (range, 0.4-9 cm). The most common combination of discordant tumor histology among patients with ≥ 2 tumors was clear-cell (cc) renal-cell carcinoma (RCC) with chromophobe RCC (3 cases, 19%). In 3 patients (19%), a single tumor was noted to have 2 distinct patterns; all patients had ccRCC with papillary RCC. Three (20%) of 15 patients developed metastatic disease. The median cancer-free survival time for patients with metastasis was 2 months. Conclusion Multiple, discordant renal pathology represents a rarely reported entity in patients receiving nephrectomy. We introduce the largest cohort of synchronous renal tumors, of which ccRCC/chromophobe RCC was the most common pairing.
AB - Background While RCC is the most common primary renal neoplasm, few cases of ipsilateral renal lesions of different RCC histologic subtypes have been described. The objective of this study was to evaluate our experience with synchronous, histologically unique, primary renal neoplasms within the same kidney. Patients and Methods We retrospectively analyzed 2 institutional nephrectomy databases from 2000 to 2013. The study cohort comprised 15 patients with multiple, discordant renal histology after partial or radical nephrectomy. Demographic data, immunohistochemical analysis, and clinical course were assessed and analyzed. Results Eight patients (53%) were black, 10 (60%) were male, and 5 (36%) were tobacco users. Median follow-up time was 13 months (range, 1-62 months), and 9 patients (56%) underwent radical nephrectomy. Among 36 tumors, the median tumor size was 2.3 cm (range, 0.4-9 cm). The most common combination of discordant tumor histology among patients with ≥ 2 tumors was clear-cell (cc) renal-cell carcinoma (RCC) with chromophobe RCC (3 cases, 19%). In 3 patients (19%), a single tumor was noted to have 2 distinct patterns; all patients had ccRCC with papillary RCC. Three (20%) of 15 patients developed metastatic disease. The median cancer-free survival time for patients with metastasis was 2 months. Conclusion Multiple, discordant renal pathology represents a rarely reported entity in patients receiving nephrectomy. We introduce the largest cohort of synchronous renal tumors, of which ccRCC/chromophobe RCC was the most common pairing.
KW - Clear-cell renal-cell carcinoma
KW - Histology
KW - Papillary renal-cell carcinoma
KW - Pathology
KW - Renal-cell carcinoma
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U2 - 10.1016/j.clgc.2015.10.013
DO - 10.1016/j.clgc.2015.10.013
M3 - Article
C2 - 26613833
AN - SCOPUS:84960106870
SN - 1558-7673
VL - 14
SP - e171-e175
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 2
ER -