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Case Reports
. 2018 Dec 9;11(1):e224273.
doi: 10.1136/bcr-2018-224273.

Primitive neuroectodermal tumour with synchronous ipsilateral clear cell carcinoma of the kidney

Mohamed Taha  1 , Nur M Mohammed  2 , Stephen Crowther  2 , Rustom P Manecksha  1 , Arun Z Thomas  1
Affiliations
Case Reports

Primitive neuroectodermal tumour with synchronous ipsilateral clear cell carcinoma of the kidney

Mohamed Taha et al. BMJ Case Rep. .

Abstract

We report the first case of a synchronous ipsilateral primitive neuroectodermal tumour (PNET) and clear cell renal cell carcinoma of the kidney. A 37-year-old man presented to the emergency department with a 24-hour history of colicky abdominal pain and visible haematuria. He had no relevant surgical or medical history. Physical examination was unremarkable apart from mild left flank tenderness. Triphasic CT of the abdomen and pelvis showed two solid lesions in the left kidney. Further staging CT of the chest showed no evidence of local or distal metastasis. He subsequently underwent laparoscopic radical nephrectomy. Pathological analysis of the kidney showed two synchronous renal tumours, a clear cell carcinoma and PNET of the kidney. The patient received adjuvant chemotherapy according to Ewing's sarcoma chemotherapy protocol. Surveillance CT scans at 3, 6 and 12 months showed no evidence of disease recurrence or metastasis.

Keywords: pathology; urological cancer; urological surgery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
A coronal section of the CT scan showing the lower pole renal lesion which came as PNET of the kidney. PNET, primitive neuroectodermal tumour.
Figure 2
Figure 2
An axial section of the CT scan showing the upper pole renal lesion which came as RCC after histology. RCC, renal cell carcinoma.
Figure 3
Figure 3
Two distinct tumours are present in this nephrectomy specimen. A larger tumour is present in the lower pole and has a solid tan brown cut surface with extensive necrosis (PNET). A second smaller tumour is present in the upper pole with yellow solid and cystic cut surface (CCRCC). CCRCC, clear cell renal cell carcinoma; PNET, primitive neuroectodermal tumour.
Figure 4
Figure 4
High power view of the smaller tumour which shows classical morphology of clear cell renal cell carcinoma.
Figure 5
Figure 5
High power views of the larger tumour showing diffuse sheets of undifferentiated cell with moderate clear cytoplasm and vesicular nuclei.
Figure 6
Figure 6
The tumour is negative for pan cytokeratin AE1/AE3.
Figure 7
Figure 7
The tumour shows diffuse strong membranous staining with CD99.
See this image and copyright information in PMC

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