title: Small cell carcinoma of the kidney: a clinicopathologic study of 14 cases.
abstract: Small cell carcinoma of the kidney is distinctively rare. We searched pathology files in 2 institutions and found 14 cases of renal small cell carcinoma. The patients' mean age at diagnosis was 59 years (range, 22-75 years); 8 were women, and 6 were men. Patients usually presented with hematuria (n = 6) and abdominal pain (n = 5). The mean tumor size was 7.1 cm (range, 3.5-14.0 cm). The small cell carcinoma was pure in 9 cases and mixed with high-grade urothelial carcinoma in 5 cases. None was associated with any type of renal cell carcinoma. Tumor necrosis was present in all cases, and lymphovascular invasion was identified in 6 cases. The tumor invaded the perinephric adipose tissue in 13 cases and was confined to the kidney in only 1 case. Lymph node metastases were identified in all patients who underwent lymph node dissection (5/5). On immunostains, the small cell carcinoma cells were positive for pancytokeratin (11/12), chromogranin (6/9), and synaptophysin (8/9). Follow-up data were available for 13 patients, and 11 died of small cell carcinoma at a mean of 15 months (range, 4-31 months) after diagnosis. Of the 2 surviving patients, 1 was alive at 5 months after diagnosis, and the other, whose disease was confined to the kidney, was alive with no evidence of disease at 137 months. In summary, renal small cell carcinoma is a highly aggressive disease that often presents at an advanced stage with widespread metastases. Patients usually have a poor clinical outcome despite multimodal therapy. The frequent coexistence of small cell carcinoma with urothelial carcinoma suggests that renal small cell carcinomas may evolve from a preexisting urothelial carcinoma.
authors: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors: Qiusheng
authors: Q
authors: Si
authors: Jane
authors: J
authors: Dancer
authors: Melissa L
authors: ML
authors: Stanton
authors: Pheroze
authors: P
authors: Tamboli
authors: Jae Y
authors: JY
authors: Ro
authors: Bogdan A
authors: BA
authors: Czerniak
authors: Steven S
authors: SS
authors: Shen
authors: Charles C
authors: CC
authors: Guo
mesh_terms: D000328:Adult; D000368:Aged; D018288:Carcinoma, Small Cell / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000556:secondary; D002295:Carcinoma, Transitional Cell / Q000473:pathology; D002864:Chromogranins / Q000032:analysis; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007633:Keratins / Q000032:analysis; D007668:Kidney / Q000473:pathology; D007680:Kidney Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016708:Synaptophysin / Q000032:analysis
chemical_list: D002864:Chromogranins; D016708:Synaptophysin; D007633:Keratins