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Composite renal cell carcinoma with clear cell renal cell carcinomatous and carcinoid tumoral elements: a first case report
  1. A Bressenot1,
  2. C Delaunay1,
  3. G Gauchotte1,
  4. A Oliver2,
  5. G Boudrant3,
  6. K Montagne1
  1. 1Department of Pathology, Hopital de Brabois, CHRU Nancy, Nancy, France
  2. 2Department of Radiology, Hopital de Brabois, CHRU Nancy, Nancy, France
  3. 3Department of Urology, Hopital de Brabois, CHRU Nancy, Nancy, France
  1. Correspondence to Dr A Bressenot, Service d'Anatomie et de Cytologie Pathologiques, CHU de Brabois, Allée du Morvan, 54511 Vandoeuvre-lès-Nancy Cedex, France; a.bressenot{at}chu-nancy.fr

Abstract

Renal endocrine tumours are extremely rare, and carcinoid tumoral elements in renal cell carcinoma have never been reported. This is the first report of a composite renal cell carcinoma containing a clear cell renal cell carcinoma associated with carcinoid tumoral elements, in a patient with synchronous metastatic disease. In the absence of specific radiological and clinical manifestations, typical morphological features as well as an immunostaining profile of neuroendocrine differentiation were identified by microscopy. Secondary nodal and liver localisations were characterised by carcinoid elements only. Despite antiangiogenic therapy, liver metastasis progressed, suggesting that adjuvant therapy cannot be based on the presence of the clear cell renal cell carcinoma component. In this context, extensive tissue sampling is recommended to reveal the endocrine component that is the most aggressive element of such a composite carcinoma.

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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