Department of Pathology, Hopital de Brabois, CHRU Nancy, Nancy, France.
J Clin Pathol. 2010 Feb;63(2):174-6. doi: 10.1136/jcp.2009.070292.
Renal endocrine tumours are extremely rare, and carcinoid tumoral elements in renal cell carcinoma have never been reported. This is the first report of a composite renal cell carcinoma containing a clear cell renal cell carcinoma associated with carcinoid tumoral elements, in a patient with synchronous metastatic disease. In the absence of specific radiological and clinical manifestations, typical morphological features as well as an immunostaining profile of neuroendocrine differentiation were identified by microscopy. Secondary nodal and liver localisations were characterised by carcinoid elements only. Despite antiangiogenic therapy, liver metastasis progressed, suggesting that adjuvant therapy cannot be based on the presence of the clear cell renal cell carcinoma component. In this context, extensive tissue sampling is recommended to reveal the endocrine component that is the most aggressive element of such a composite carcinoma.
肾脏内分泌肿瘤非常罕见，而肾细胞癌中的类癌肿瘤成分从未被报道过。这是首例报告在同步转移性疾病患者中，含有透明细胞肾细胞癌相关类癌肿瘤成分的复合肾细胞癌。在缺乏特定的影像学和临床表现的情况下，通过显微镜观察到了典型的形态学特征和神经内分泌分化的免疫染色特征。继发性淋巴结和肝脏定位仅由类癌成分组成。尽管进行了抗血管生成治疗，肝转移仍进展，表明辅助治疗不能基于透明细胞肾细胞癌成分的存在。在这种情况下，建议广泛组织取样以揭示内分泌成分，这是此类复合癌中最具侵袭性的成分。
