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Case Reports
. 2024 Jun 8;16(6):e61940.
doi: 10.7759/cureus.61940. eCollection 2024 Jun.

Combined Clear Cell Renal Cell Carcinoma and Chromophobe Renal Cell Carcinoma: A Case Report

Abdelrazak Meliti  1 , Hosam Alardati  1 , Manal Khayat  2 , Abdullah Alruqi  3
Affiliations
Case Reports

Combined Clear Cell Renal Cell Carcinoma and Chromophobe Renal Cell Carcinoma: A Case Report

Abdelrazak Meliti et al. Cureus. .

Abstract

Renal cell carcinoma (RCC) is a diverse array of cancers arising from renal tubular epithelial cells. RCC presenting with distinct morphological subtypes, such as the simultaneous presence of chromophobe RCC (chRCC) and clear cell RCC (ccRCC) lesions within the same kidney, is rare. We present the case of a 79-year-old female with a history of breast cancer who presented to our facility with right flank pain. Further investigations using CT of the abdomen and pelvis revealed a Bosniak type 4 cyst with a mural nodule in the right kidney. Furthermore, another well-defined, solid lesion measuring 2.8 × 2.6 cm was observed in the same area. The patient underwent a right radical nephrectomy. The macroscopic examination of the kidney revealed the presence of three cysts, with the largest measuring up to 7.5 cm. Moreover, a distinctly demarcated, golden-yellow, solid mass was discerned in the superior pole of the kidney. The mass showed a heterogeneous cut surface with solid and cystic components, measuring 2.8 × 2.6 × 2.0 cm. A less extensive but well-defined, uniform tan mass was also identified within the wall of the largest cyst, which measured 1.2 × 1.0 × 0.7 cm. At this point, the diagnosis of ccRCC and chRCC was established.

Keywords: computed tomography; kidney; multiple tumors; nephrectomy; renal cell carcinoma.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. H&E staining reveals a cell exhibiting clear cytoplasm arranged in a nested architecture, accompanied by fine arborizing vascularity (10× magnification)
Figure 2
Figure 2. Immunohistochemical staining demonstrates strong, diffuse positivity for vimentin in both the cytoplasm and membrane (10× magnification)
Figure 3
Figure 3. H&E staining reveals tumor cells arranged in a solid nest pattern with reticulated and eosinophilic cytoplasm, accompanied by hyperchromatic wrinkled nuclei (10× magnification)
Figure 4
Figure 4. Immunohistochemical staining shows strong, diffuse positivity for cytokeratin 7 in both the cytoplasm and membrane (10× magnification)
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