Papillary renal cell carcinoma

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Mohamed Mourad Gargouri
Walid Bargaoui
Yousri Kallel
Yassine Nouira

Abstract

Background: Papillary renal cell carcinoma (PRCC) represent 10 to 15% of renal tumours in adults. They contain more than 75% of tubule-papillary structure and are divided histologically into two subtypes. The distinction between these two sub-types is essential because of different prognosis.
Aim: To describe the main clinical, radiological, therapeutic and prognostic features of these tumors. A comparative analysis between the two sub histological types was performed. Methods: This is a retrospective study, from January 2000 to December 2010, concerning 27 patients operated for PRCC. Clinical
data was taken from medical observations and radiological analysis was based on CT findings. A second analysis of blades was made in doubtful cases to clarify the histological subtype.
Results: PRCC represented 11.3% of renal tumors operated during this period. Mean patients’ age was 62 years with a male predominance (sex ratio 3.5). All tumors were unilateral and mean tumor size was 7 cm. There was no clinical or radiological sign suggestive of this histological type. Treatment consisted of radical nephrectomy in 74% of the cases and nephron sparing surgery in 26% of the cases. We found 17 subtype 1 tumors and 10 subtype 2 tumors. The five year overall and disease-free survival rate were, respectively 86% and 90% in type 1 tumors and 57% and 54% in type tumors.
Conclusion: PRCC is the second most common renal cancer in adults. They have no clinical or radiological specific signs suggesting their diagnosis. The distinction between these two sub histological types is essential as subtype 1 tumors have a better prognosis.

Keywords:

Kidney - Papillary carcinoma - pathology - Surgery - prognosis

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References

  1. Pignot G, Elie C, Conquy S, Vieillefond A, Flam T et al. Survival analysis of 130 patients with papillary renal cell carcinoma: prognostic utility of type 1 and type 2 subclassification. Urology 2007; 69,2:230-5.
  2. Allory Y, Ouazana D, Boucher E, Thiounn N, Vieillefond A. Papillary renal cell carcinoma: Prognostic value of morphological subtypes in a clinicopathologic study of 43 cases. Virchows Arch 2003; 442:336-42.
  3. Combes F, Saidi A, Delaporte V, et al. Les tumeurs tubulo-papillaires du rein: intérêt pronostique de la distinction type 1/type 2: à propos de 58 cas. Prog Urol 2005;15:1062-9.
  4. Sukov WR, Lohse CM, Leibovich BC, Houston Thompson R, Cheville JC. Clinical and pathological features associated with prognosis in patients with papillary renal cell carcinoma. J Urol 2012;187:54-9.
  5. Rao Q, Chen YJ, Wang DJ, et al. Renal cell carcinoma in children and young adults: Clinicopathological, immunohistochemical, and VHL gene analysis of 46 cases with follow-up. Int J Surg Pathol 2011;19,2:170-9.
  6. Cohen HT, McGovern FJ. Renal-cell carcinoma. New Engl J Med 2005; 353:2477-90.
  7. Amin MB, Corless CL, Renshaw AA et al. Papillary (chromophil) renal cell carcinoma: Histomorphologic characteristics and evaluation of conventional pathologic prognostic parameters in 62 cases. Am J Surg Pathol 1997;21:621-35.
  8. Kovacs G, Fuzesi L, Emanual A, Kung HF. Cytogenetics of papillary renal cell tumors. Genes Chromosomes Cancer 1991;3:249-55.
  9. Wadt KA, Gerdes AM, Hansen TV et al. Novel germline c-MET mutation in a family with hereditary papillary renal carcinoma. Familial Cancer 2012;11:189-94.
  10. Delahunt B, Eble JN. Papillary renal cell carcinoma: a clinicopathologic and immunohistochemical study of 105 tumors. Mod Pathol 1997;10:537-44.
  11. Jones TD, Eble JN,Wang M, MacLennan GT, Delahunt B, Brunelli M, et al. Molecular genetic evidence for the independent origin of multifocal papillary tumors in patients with papillary renal cell carcinomas. Clin Cancer Res 2005;11:7226-33.
  12. Blute ML, Thibault GP, Leibovich BC, Cheville JC, Lohse CM, Zincke H. Multiple ipsilateral renal tumors discovered at planned nephron sparing surgery: importance of tumor histology and risk of metachronous recurrence. J Urol 2003;170:760-3.
  13. Cheville JC, Lohse CM, Zincke H, Weaver AL, Blute ML. Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma. Am J Surg Pathol 2003; 27:612-24.
  14. Méjean A, Hopirtean V, Bazin JP et al. Prognostic factors for the survival of patients with papillary renal cell carcinoma: Meaning of histological typing and multifocality. J Urol 2003; 170,3:764-7.
  15. Blute ML, Itano NB, Cheville JC, Weaver AL, Lohse CM, Zincke H. The effect of bilaterality, pathological features and surgical outcome in nonhereditary renal cell carcinoma. J Urol 2003; 169:1276-81.
  16. Gossios K, Argyropoulu M, Vazakas P et al. Bilateral papillary renal cell carcinoma. Eur Radiol 2001; 130:105-10.
  17. Vikram R, Ng SC, Tamboli P, Tannir N et al. Papillary renal cell carcinoma: radiologic-pathologic correlation and spectrum of disease. Radiographics 2009;29:741-54.
  18. [Yamada T, Endo M, Tsuboi M, et al. Differentiation of pathologic subtypes of papillary renal cell carcinoma on CT. AJR Am J Roentgenol 2008;191:1559-63.
  19. Lopez-Beltran A, Scarpelli M , Montironi R ,Kirkali Z. 2004 WHO classification of the renal tumors of the adults. Eur urol 2006;49(5):798- 805.
  20. Gupta R, Billis A, Shah RB et al. Carcinoma of the collecting duct of Bellini and renal medullary carcinoma: Clinicopathologic analysis of 52 cases of rare aggressive subtypes of renal cell carcinoma with a focus on their interrelationship. Am J Surg Pathol 2012; 36:1265-1278
  21. Blel A, Kourda N, Baltagi-Ben Jilani S, Zermani R. Intérêt pronostique du sous-typage morphologique des tumeurs tubulopapillaires du rein et expression de MUC1. Prog Urol 2008;18(9):575-9.
  22. Yang XJ, Tan MH, Kim HL, Ditlev JA et al. A molecular classification of papillary renal cell carcinoma. Cancer Res 2005; 65:5628-37.
  23. Fleming S, O'Donnel M. Surgical pathology of renal epithelal neoplasms: Recent advances and current status. Histopathol 2000; 36:195-202.
  24. Ishikawa I, Kovac J. High incidence of papillary renal cell tumours in patients on chronic haemodialysis . Histopathology 1993; 22,2:135-40.
  25. Bai S, Cao D, Robirds D, Branson J, Bing Z. Gain of Chromosomes 1, 2, 7, 10, 13 and 17 in an acquired cystic kidney disease associated renal cell carcinoma. Open J Pathol 2012;2:1-5
  26. [26] Gunawan B, Von Heydebreck A, Fritsch T et al. Cytogenetic and morphologic typing of 58 papillary renal cell carcinomas: Evidence for a cytogenetic evolution of type 2 from type 1 tumors. Cancer Res 2003;63:6200-5.
  27. Fernandez-Acenero MJ, Cazorla A, Manzarbeitia F. Immunohistochemistry for the differential diagnosis of renal tumors with oncocytic features. Urol Oncol. 2011;29(5):545-9.