title: Papillary Renal Cell Carcinoma Arising in a Lymph Node Metastasis of a Testicular Teratoma: A Very Rare Occurrence.
abstract: We present a case of a teratoma with somatic type malignancy (TSM) in the form of papillary renal cell carcinoma (pRCC) within supraclavicular and retroperitoneal lymph node metastases of a testicular pure teratoma. Resection of both masses revealed a teratoma without any other germ cell tumor component. A papillary carcinoma component was also detected intermingled with the teratomatous elements. The carcinoma cells displayed eosinophilic cytoplasm and prominent nucleoli. Groups of foamy histiocytes in the fibrovascular cores was a striking finding that brought pRCC to mind. Immunoreactivity for CK7, PAX8, AMACR, CD10, napsin, and vimentin along with morphologic findings confirmed renal cell differentiation. No radiological evidence of a primary renal cell carcinoma was found in the kidney. Consequently, pRCC arising in a teratoma was diagnosed. TSM is described as teratoma with a malignant component that is typically encountered in other organs and tissues. TSM in the form of pRCC is an extremely rare entity. Our case is the second example of a testicular germ cell tumor metastasis with a somatic malignancy in the form of pRCC. In conclusion, carcinomas of renal cell differentiation should be kept in mind as a rare form of TSM, especially in metastatic germ cell tumors.
authors.affiliation: Istanbul University, Istanbul, Turkey suleozturksari@gmail.com.
authors.forename: Sule
authors.initials: S
authors.lastname: Ozturk Sari
authors.affiliation: Istanbul University, Istanbul, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Ozluk
authors.affiliation: Istanbul University, Istanbul, Turkey.
authors.forename: Orhun Cig
authors.initials: OC
authors.lastname: Taskin
authors.affiliation: Istanbul University, Istanbul, Turkey.
authors.forename: Beldan
authors.initials: B
authors.lastname: Polat
authors.affiliation: Istanbul University, Istanbul, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Ozturk
authors.affiliation: Istanbul University, Istanbul, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Ekenel
authors.affiliation: Istanbul University, Istanbul, Turkey.
authors.forename: Isin
authors.initials: I
authors.lastname: Kilicaslan
authors.affiliation: Istanbul University, Istanbul, Turkey.
authors.forename: Bilge
authors.initials: B
authors.lastname: Bilgic
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D013724:Teratoma / Q000473:pathology* / Q000556:secondary; D013736:Testicular Neoplasms / Q000473:pathology* / Q000556:secondary
chemical_list: D014408:Biomarkers, Tumor
keywords: lymph node; metastasis; papillary renal cell carcinoma; somatic malignancy; teratoma; testis