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Case Reports
. 2022 Jul 23;22(1):113.
doi: 10.1186/s12894-022-01063-y.

Renal collision tumours: three additional case reports

Valère Belle Mbou  1 , Florian Sanglier  2 , Julia Pestre-Munier  3 , Aurélien Descazeaud  4 , François Labrousse  5
Affiliations
Case Reports

Renal collision tumours: three additional case reports

Valère Belle Mbou et al. BMC Urol. .

Abstract

Background: Multiple kidney tumours are frequently seen in hereditary syndromes and familial diseases. Renal collision tumours (RCT) are characterized by the simultaneous existence of different and unrelated tumour types within the same location in the kidney, forming a single, heterogenous lesion. RCT are uncommon histological entities with distinctive features. The most frequent subtypes include clear cell renal cell carcinoma (CCRCC), papillary renal cell carcinoma (PRCC), chromophobe renal cell carcinoma (CRCC), and collecting duct carcinoma (CDC).

Case presentation: Here, we report three sporadic cases of RCT successfully treated by nephrectomy and confirmed by histological analysis. The first case was of a 64-year-old man diagnosed with RCT composed of a stage 2 nucleolar grade 3 CCRCC and a stage 1a nucleolar grade 2 type 1 PRCC. The second case was of a 68-year-old woman diagnosed with a combined nucleolar grade 2 type 1 PRCC and an angiomyolipoma (non-assessed stage), while the third case was of a 59-year-old woman diagnosed with a combined stage 1a nucleolar grade 3 CCRCC and a stage 1b CDC.

Conclusions: Due to the rarity of RCT, there are no standard guidelines for their management. Hence, the prognosis is considered to be associated with the most aggressive component, possibly the tumour with the highest nucleolar grade and stage. The histogenesis of RCT remains debated, and increase in knowledge regarding this can help enable the development of targeted therapies for advanced or metastatic tumours.

Keywords: Histogenesis; Histology; Kidney; Prognostic; Tumour.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Abdominal computed tomography scan showing a Bosniak 4 cystic lesion (white star) and a fleshy lesion (white line) of right kidney in Case 1 (A), a right mid-renal lesion with fat and tissular components in Case 2 (B) and a left kidney mass in Case 3 (C)
Fig. 2
Fig. 2
Histologic features of collision renal tumour associating CCRCC and PRCC (hematoxylin and eosin, immunophenotype). Renal collision tumour combining two tumours: CCRCC «T1» and PRCC «T2» (A). Tumour T1 is composed of cystic and tubular pattern of clear cell carcinoma (B). Tumour T1 is constituted with atypical clear cell (C). Tumour T2 is arranged in papillary pattern (D). CK7 immunohistochemistry is negative in T1 (E) and positive in T2 (F) whereas CA-IX immunohistochemestry is positive in T1 (G) and negative in T2 (H)
Fig. 2
Fig. 2
Histologic features of collision renal tumour associating CCRCC and PRCC (hematoxylin and eosin, immunophenotype). Renal collision tumour combining two tumours: CCRCC «T1» and PRCC «T2» (A). Tumour T1 is composed of cystic and tubular pattern of clear cell carcinoma (B). Tumour T1 is constituted with atypical clear cell (C). Tumour T2 is arranged in papillary pattern (D). CK7 immunohistochemistry is negative in T1 (E) and positive in T2 (F) whereas CA-IX immunohistochemestry is positive in T1 (G) and negative in T2 (H)
Fig. 3
Fig. 3
Histologic features (hematoxylin and eosin) of renal collision tumour combining PRCC «T1» and AML «T2»
Fig. 4
Fig. 4
Histologic features of renal collision tumour associating CCRCC «T1» and CDC «T2» (hematoxylin and eosin, immunophenotype). Renal collision tumour combining two tumours: CCRCC «T1» and CDC «T2» (A). CD10 immunohistochemistry is positive in T1 and negative in T2 (B) whereas CD117 immunohistochemestry is negative in T1 and positive in T2 (C)
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