title: Immunohistochemical basis for adjuvant anti-angiogenic targeted therapy for renal carcinoid: initial case report.
abstract: OBJECTIVE
  To evaluate the immunohistochemical profile of a carcinoid (low grade neuroendocrine tumor of the kidney) from a patient with lymph node positive disease who remains disease free for 31 months after radical nephrectomy, lymph node dissection, and adjuvant therapy with sunitinib malate.
  
  
  METHODS
  Immunohistochemical staining was performed for chromogranin, synaptophysin, CD31, VEGF, HIF-1α, HIF-2, and Glut-1. Staining was evaluated in 3 high-power fields and samples scored as strongly positive (3+), moderately positive (2+), weakly positive (1+), or negative (0). A clear cell renal cell carcinoma was used as positive control.
  
  
  RESULTS
  Immunohistochemical staining was strongly positive VEGF, weak to moderately positive for HIF-2, and negative for HIF-1α and Glut-1.
  
  
  CONCLUSIONS
  Our case of primary renal carcinoid stained intensely for VEGF and HIF-2, consistent with a VHL-HIF1-HIF2-Glut1 independent pathway for VEGF activation. These data suggest that like other neuroendocrine tumors, primary renal carcinoid is a potential target for anti-angiogenic therapy with sunitinib.
authors.affiliation: Department of Urology, University of California Irvine Medical Center, Orange, CA 92868, USA. finds@uci.edu
authors.forename: David S
authors.initials: DS
authors.lastname: Finley
authors.forename: Navneet
authors.initials: N
authors.lastname: Narula
authors.forename: Vladimir A
authors.initials: VA
authors.lastname: Valera
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Merino
authors.forename: John
authors.initials: J
authors.lastname: Fruehauf
authors.forename: Mark Li-cheng
authors.initials: ML
authors.lastname: Wu
authors.forename: W Marston
authors.initials: WM
authors.lastname: Linehan
authors.forename: Ralph V
authors.initials: RV
authors.lastname: Clayman
mesh_terms: D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D042501:Angiogenic Proteins / Q000037:antagonists & inhibitors* / Q000378:metabolism; D002276:Carcinoid Tumor / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D020533:Angiogenesis Inhibitors; D042501:Angiogenic Proteins