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Case Reports
. 2020 Jun 28;3(5):196-199.
doi: 10.1002/iju5.12186. eCollection 2020 Sep.

Synchronous bilateral renal cell carcinomas with differing histologies

Ryu Shigehisa  1 , Takashi Karashima  1 , Shu Kobayashi  1 , Kaya Atagi  1 , Daigo Takemori  1 , Hideo Fukuhara  1 , Satoshi Fukata  1 , Ichiro Murakami  2 , Naoto Kuroda  3 , Keiji Inoue  1
Affiliations
Case Reports

Synchronous bilateral renal cell carcinomas with differing histologies

Ryu Shigehisa et al. IJU Case Rep. .

Abstract

Introduction: Bilateral renal cell carcinomas with different histological types are rare. We report herein the first description of bilateral renal carcinomas with clear cell renal cell carcinoma and mucinous tubular and spindle cell carcinoma occurring synchronously.

Case presentation: A 62-year-old man was referred to our hospital with bilateral renal tumors. The tumors on each side showed different findings from both contrast-enhanced computed tomography and magnetic resonance imaging. The tumors were partially resected. Histopathological and immunohistochemical examination of the left renal tumor diagnosed clear cell renal carcinoma. Histopathological and immunohistochemical examination of the right renal tumor diagnosed mucinous tubular and spindle cell carcinoma.

Conclusion: We encountered a case with clear cell renal cell carcinoma and mucinous tubular and spindle cell carcinoma occurring simultaneously in bilateral kidneys.

Keywords: bilateral; clear cell renal cell carcinoma; mucinous tubular and spindle cell carcinoma; renal cell carcinoma; synchronous.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Preoperative CT of bilateral renal tumors. The left renal tumor is 42 mm in diameter and shows well‐defined margins and irregular contrast in the arterial phase (a) and early drainage in the renal parenchymal phase (b). The right renal tumor is 26 mm in diameter and shows well‐defined margins without contrast‐enhancement in both arterial and renal parenchymal phases (c,d).
Fig. 2
Fig. 2
Abdominal MRI of bilateral renal tumors. The left renal tumor shows solid hypointensity on T1‐weighted imaging (a) and irregular hyperintensity on T2‐weighted imaging (b). The right renal tumor appears isointense on T1‐weighted imaging (d) and hypointense on T2‐weighted imaging (e). Both tumors show strong signals on DWI (left; c and right; f).
Fig. 3
Fig. 3
Macro‐ and microscopic findings of bilateral renal tumors. Both tumors were partially resected by robot‐associated laparoscopic surgery. The cross‐sectional surface of the left renal tumor is lobulated and heterogeneously yellow with bleeding and necrosis (a). The right renal tumor is a white and grayish‐white circular mass with internal hemorrhage and necrosis (e). HE staining of the left renal tumor shows an alveolar growth pattern with cells containing clear cytoplasm, and displays abundant vascular plexuses and sparse stroma (b). Moderate to strong immunostaining for CA9 (c) and CD10 (d) is seen on the cell membrane. HE staining of the right renal tumor shows a slim, tubular structure containing viscous liquid and spindle cells (f). Strong immunostaining for CK7 (g) and AMACR (h) is diffusely evident in cytoplasm. Weak focal positivity for CD10 is seen (i). Alcian blue staining identifies mucus in the stroma (j).
See this image and copyright information in PMC

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