[Collecting duct carcinoma associated with renal stones].
Collecting duct carcinoma is an extremely rare disease, representing less than 1% of all renal tumours. The authors report the case of a 72-year-old patient presenting with right low back pain associated with episodes of total macroscopic haematuria. Imaging showed a heterogeneous mass in the upper pole of the right kidney associated with pyelocaliceal stones. Multiple secondary lesions were observed in the liver. Macroscopically, the mid-renal tumour was 7.5 cm in diameter surrounding the stone-containing pyelocaliceal cavities. This tumour had spread to the cortex and invaded the perirenal fat. Histologically, the tumour was composed of ducts lined by cells with a hobnail appearance in an abundant desmoplastic and neutrophil-rich inflammatory stroma. Immunohistochemistry showed very intense labelling of tumour cells with cytokeratins: KL1, 7, 19, and 34_E12 and slightly less intense labelling with UER, Vimentin, EMA, and BNH9, while cytokeratin 20 was negative. The diagnosis of Fuhrman grade 3 collecting duct carcinoma associated with renal stones and liver metastases was adopted. The patient died postoperatively. The main differential diagnosis was urothelial carcinoma with a glandular component. In the present case, the diagnosis was made more difficult by the concomitant presence of renal stones. The diagnosis was established by histology and immunohistochemistry.
Kourda
Nadia
N
Service d'Anatomie et de Cytologie Pathologiques, Hôpital Charles Nicolles, Tunis, Tunisie. nadia.kourda@rns.tn
El Attat
Rabii
R
Derouiche
Amine
A
Ben Reguiga
Maher
M
Ben Slama
Sana
S
Chebil
Mohamed
M
Ben Jilani
Sarra Baltagi
SB
Zermani
Rachida
R
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007669:Kidney Calculi / Q000150:complications*; D007680:Kidney Neoplasms / Q000150:complications* / Q000175:diagnosis; D008297:Male