The diagnosis,surgical treatment,and comprehensive treatment of renal cell carcinoma with inferior vena cava tumor thrombus have advanced rapidly in recent years. Both the survival and quality of life of the patients have remarkably improved. Further advance in basic research may provide new direction of management of renal cell carcinoma.
Carcinoma, Renal Cell ; complications ; diagnosis ; therapy ; Embolism ; diagnosis ; etiology ; therapy ; Humans ; Kidney Neoplasms ; complications ; diagnosis ; therapy ; Venae Cavae

Up to 5% of all small cell carcinomas develop at extrapulmonary sites. Primary small cell carcinomas originating in the kidney are extremely rare neoplasms. Here we report a case of primary small cell carcinoma of the kidney. A nephrectomy was performed on a 52-year-old female patient to remove a large tumor located in the right kidney. The histology and immunohistochemistry of the resected tumor revealed a pure small cell carcinoma with invasion into the renal capsule. The patient received postoperative adjuvant chemotherapy with etoposide and cisplatin. The patient has been monitored with regular check ups and remains stable with no recurrence at 28 months after the initial diagnosis.
*Nephrectomy ; Middle Aged ; Kidney Neoplasms/*diagnosis/drug therapy/surgery ; Humans ; Female ; Carcinoma, Small Cell/*diagnosis/drug therapy/surgery

Teratoid Wilms' tumor is a rare renal tumor. Fourteen cases have been reported. A 14-month-old girl was presented to us. She had a right renal mass which was diagnosed as a Wilms' tumor in another hospital. She had been treated with chemotherapy but failed to respond to it. The nephrectomy specimen revealed an encapsulated mass of which the cut surface was solid, firm, gray to yellow tan. Microscopically, the stromal elements were predominant, especially comparing with few blastemal element, but the degree of heterologous differentiation was sufficient to warrant the diagnosis of teratoid Wilms' tumor.
Diagnosis ; Drug Therapy ; Female ; Humans ; Infant ; Kidney Neoplasms ; Nephrectomy ; Triacetoneamine-N-Oxyl ; Wilms Tumor*

Although congenital renal tumors are rare, congenital mesoblastic nephroma (CMN) is the most common renal tumor in early infancy. It is non-metastatic, well differentiated, amenable to surgical removal, and carries a good prognosis. Polyhydramnios has been detected in most of the published cases of CMN. However, we experienced a rare case of fetal CMN associated with oligohydramnios. A 28-yr old woman at 34 weeks of gestation was referred to our hospital for oligohydramnios and a fetal abdominal mass. An ultrasonography revealed a huge, well-encapsulated mass arising from the right kidney. An emergency cesarean section was performed due to fetal distress. After birth, despite intensive neonatal care, the baby died because of renal failure, disseminated intravascular coagulopathy, pulmonary edema, together with other problems.
Pregnancy ; Oligohydramnios/*diagnosis/therapy ; Nephroma, Mesoblastic/*diagnosis/therapy ; Kidney Neoplasms/*diagnosis/therapy ; Infant, Newborn ; Humans ; Fetal Diseases/etiology/prevention & control ; Female ; Fatal Outcome ; Cesarean Section ; Adult

Primary non-Hodgkin's lymphoma of bone (PLB) is rare, and generally presents as a single extensive and destructive bone lesion. Histopathologically, most cases present as diffuse large B-cell lymphoma, and T-cell lymphoma is rare. By contrast, multiple myeloma is a disease defined as the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. We report a case of multiple myeloma that developed during treatment of PLB in a type of T-cell. A 48-yr-old man was diagnosed as T-cell PLB, stage IE, 18 months ago. The patient received the chemoradiotherapy and salvage chemotherapy for PLB. However, the lymphoma progressed with generalized bone pain, and laboratory findings showed bicytopenia and acute renal failure. On bone marrow biopsy, the patient was diagnosed as having multiple myeloma newly developed with primary T-cell lymphoma of bone. In spite of chemotherapy, the patient died of renal failure.
Bone Neoplasms/*complications/diagnosis/therapy ; Fatal Outcome ; Humans ; Kidney Failure, Acute/etiology ; Lymphoma, T-Cell/*complications/diagnosis/therapy ; Male ; Middle Aged ; Multiple Myeloma/*complications/diagnosis/therapy

Radio-frequency ablation (RFA) is a curative treatment for hepatocellular carcinoma (HCC). Percutaneous RFA has been shown to be beneficial for patients with small renal cell carcinoma (RCC) lacking indications for resection. We experienced the case of a 53-year-old male who had conditions that suggested HCC, RCC, and alcoholic liver cirrhosis. Abdominal contrast-enhanced computed tomography (CT) and magnetic resonance image showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 1.9 cm hypervascular mass in the left kidney. These findings were compatible with the double primary cancers of HCC and RCC. Transarterial chemoembolization (TACE) was performed to treat the HCC. After the TACE, a focal lipiodol uptake defect was noticed on a follow up CT images and loco-regional treatment was recommended. Therefore, we performed RFAs to treat HCC and RCC. There was no evidence of recurrence in the follow up image after 1 month.
Carcinoma, Hepatocellular/complications/*diagnosis/therapy ; Carcinoma, Renal Cell/complications/*diagnosis/therapy ; Catheter Ablation ; Humans ; Kidney Neoplasms/complications/*diagnosis/therapy ; Liver Cirrhosis/complications/*diagnosis ; Liver Neoplasms/complications/*diagnosis/therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo study the characteristics, diagnosis,treatment and prognosis of incidental renal cell carcinoma(RCC).

METHODS109 cases of incidental RCC treated in 20 years were analyzed retrospectively and compared with 247 cases of non-incidental RCC.

RESULTSThe age, sex and side between incidental RCC and non-incidental RCC were not significant (P > 0.05). Compared to the non-incidental RCC,the diameter of incidental RCC [(4.1 +/- 1.7) cm] was smaller and its stage was lower (P < 0.01). Ultrasonography and CT can improve the detection rate of incidental RCC significantly, and operation is more effective for incidental RCC than for non-incidental RCC (P < 0.01). The 3 and 5 year cancer specific survival rates in patients with incidental RCC were higher than those of non-incidental RCC(P < 0.01). The detection rate of incidental RCC was higher from 1990 to 1999 (39.3%) than from 1980 to 1989 (15.6%) (P < 0.01).

CONCLUSIONSIncidental RCC is not another type of RCC, but a developing stage of RCC without appearance of a symptoms. Ultrasonography and CT are important to diagnose incidental RCC. Low pathological stage, small size, early diagnosis, and radical nephrectomy indicate better prognosis of incidental RCC.

Adult ; Aged ; Carcinoma, Renal Cell ; diagnosis ; mortality ; therapy ; Female ; Humans ; Kidney Neoplasms ; diagnosis ; mortality ; therapy ; Male ; Middle Aged ; Prognosis ; Tomography, X-Ray Computed

Primary renal lymphoma (PRL) is very rare. In order to investigate the clinical features, diagnosis, therapy and prognosis of PRL, three cases of primary renal lymphoma diagnosed definitely and treated in our hospital in the recent ten years were reported, and their clinical features, laboratory examination, pathological observation and their therapeutics were analyzed. The results indicated that the three cases of primary renal lymphoma were all male elders. Their most common symptoms were flank pain along with abdominal mass and hematuria, etc. Because of suspicion of cancer with renal involvement, the three patients all underwent laparotomy. Histological examination showed diffuse B-cell lymphoma in the three cases, and the immunophenotype was CD20 positive in all three cases. These cases were treated with combined therapeutics, including rituximab, intermittent interferon and local radiotherapy. The 2 out of 3 cases lived for more than 5 years after therapy. In conclusion, as PRL is especially rare, and often diagnosed mistakenly, it is suggested that early and definite diagnosis and individualization of treatment for PRL patients may be possible to achieve a better therapeutic result.
Aged ; Aged, 80 and over ; Antigens, CD20 ; analysis ; Humans ; Kidney Neoplasms ; diagnosis ; immunology ; therapy ; Lymphoma, B-Cell ; diagnosis ; immunology ; therapy ; Male ; Middle Aged ; Prognosis

The morphological features of a retroperitoneal teratoma in a 10-month-old girl are reported. Unlike the usual pattern of the teratoma, this tumor was composed predominantly of nephroblastomatous tissue. Histologically, glomeruloid and tubular structures were identified in nests of undifferentiated blastemal elements. Hyaline cartilage, adipose tissue, glial tissue and glands lined by mucin-secreting columnar epithelium were minor elements. A focal cystic structure lined by thin flattened epithelium was also noted. Retroperitoneal teratoma with predominance of nephroblastic elements is of interest not only because of its rarity but also because it needs to be differentiated from extrarenal Wilms' tumor, since both of these tumors have different origins.
Diagnosis, Differential ; Female ; Humans ; Infant, Newborn ; Kidney Neoplasms/*pathology ; Magnetic Resonance Imaging ; Retroperitoneal Neoplasms/drug therapy/*pathology/surgery ; Teratoma/drug therapy/*pathology/surgery ; Wilms Tumor/*pathology

PURPOSE: Collecting duct carcinoma (CDC) of the kidney is an aggressive disease with a poor prognosis, accountings for less than 1% of all renal cancers. To date, no standard therapy for CDC has been established. The aim of this study is an investigation of clinicopathologic findings of CDC and correlation of the disease status with a prognosis. MATERIALS AND METHODS: From 1996 to 2009, 35 patients with CDC were treated at eight medical centers. The diagnosis of CDC was made based on nephrectomy in 27 cases and renal biopsy in eight cases. RESULTS: Median PFS and OS for all patients were 5.8 months (95% CI 3.5 to 9.2) and 54.4 months (95% CI 0 to 109.2), respectively. The OS of patients with Stages I-III was 69.9 months (95% CI 54.0 to 85.8), while that of patients with Stage IV was 8.6 months (95% CI 0 to 23.3), which showed a statistically significant difference (p=0.01). In addition, among patients with Stage IV, the OS of patients who received a palliative treatment (immunotherapy, chemotherapy, or targeted therapy) was 18.4 months, which was higher than the OS of patients without treatment of 4.5 months. CONCLUSION: CDC is a highly aggressive form of renal cell carcinoma. Despite most of the treatments, PFS and OS were short, however, there were some long-term survivors, therefore, conduct of additional research on the predictive markers of the several clinical, pathological differences and their treatments will be necessary.
Biopsy ; Carcinoma, Renal Cell* ; Centers for Disease Control and Prevention (U.S.) ; Diagnosis ; Drug Therapy ; Gynecology* ; Humans ; Kidney ; Kidney Neoplasms ; Nephrectomy ; Palliative Care ; Prognosis ; Survivors