Burger Maximilian, Denzinger Stefan, Filbeck Thomas, Hartmann Arndt, Rössler Wolfgang, Hammerschmied Christina
Department of Urology, University of Regensburg, Germany.
ScientificWorldJournal. 2005 Jul 20;5:545-9. doi: 10.1100/tsw.2005.73.
We present one case of a metachronous, atypical, multifocal renal oncocytoma with a concomitant chromophobe renal cell carcinoma (RCC) of the contralateral side and one case of bilateral and multifocal oncocytomas. Oncocytomas are benign renal tumours that rarely appear bilateral or multifocal or with coexisting RCC. A common pathogenic denominator of oncoytomas and RCC is being discussed. The first case was a 63 years old patient presenting with a history of nephrectomy for a pT1 G1 pN0 R0 papillary RCC 4 years prior to presentation, showed two tumours of a singular kidney. Upon nephron-sparing surgery one typical and one atypical oncocytoma with an invasion of the perinephric fat were found. Comparative genomic hybridisation was performed. Both tumours revealed genetic alterations with loss of genetic material on chromosome 1p. The second case was a 62 years old patient presenting with multifocal and bilateral renal tumours of undeclared dignity upon imaging. During open exploration all tumours could be removed by nephron-sparing surgery and were identified as oncocytomas. Again comparative genomic hybridisation was performed. All 4 tumours revealed genetic alterations with loss of genetic material on chromosome 1p, one of the tumours an additional loss of chromosome 10.
我们报告了一例异时性、非典型、多灶性肾嗜酸细胞瘤,同时伴有对侧肾嫌色细胞癌(RCC),以及一例双侧多灶性嗜酸细胞瘤。嗜酸细胞瘤是良性肾肿瘤,很少表现为双侧、多灶性或与RCC并存。目前正在讨论嗜酸细胞瘤和RCC的一个常见致病因素。第一例患者为63岁,在此次就诊前4年因pT1 G1 pN0 R0乳头状RCC行肾切除术,此次检查发现单个肾脏有两个肿瘤。在实施保留肾单位手术时,发现一个典型嗜酸细胞瘤和一个非典型嗜酸细胞瘤,并侵犯肾周脂肪。进行了比较基因组杂交。两个肿瘤均显示1号染色体短臂遗传物质缺失的基因改变。第二例患者为62岁,影像学检查发现多灶性双侧肾肿瘤,性质不明。在开放探查过程中,所有肿瘤均通过保留肾单位手术切除,病理诊断为嗜酸细胞瘤。同样进行了比较基因组杂交。所有4个肿瘤均显示1号染色体短臂遗传物质缺失的基因改变,其中一个肿瘤还存在10号染色体缺失。