Eldessouki Ihab, Gaber Ola, Shehata Mahmoud A, Namad Tariq, Atallah Joseph, Masineni Harsha, Abdel Karim Nagla
Division of Hematology/Oncology, Stem Cell Transplantation, University of Cincinnati, Cincinnati, OH, USA.
Department of Internal Medicine, St. John Hospital & Medical Center, Cincinnati, OH, USA.
SAGE Open Med Case Rep. 2019 Aug 28;7:2050313X19869475. doi: 10.1177/2050313X19869475. eCollection 2019.
The incidence of renal cell carcinomas in adults ranges has been increasing over the past decades in both men and women. Once the incidence was 2.9%, now is reported to have increased to 3%-5% with male predominance according to the most recent reports of cancer statistics. The disease typically describes a group of different histopathological subtypes; the most common is clear cell carcinoma which accounts for 70%-80% of the diagnosed cases, while papillary renal cell carcinoma and chromophobe types represent 20% and 5%, respectively. In 1996, the renal cell carcinomas Heidelberg classification was introduced by Delahunt et al. It divides renal cell tumors into benign and malignant parenchymal neoplasms, excluding Wilm's tumor and secondary metastases and limiting each subcategory to the most commonly documented genetic abnormalities, if applicable. In this report, we discuss a case of metastatic type I papillary renal cell carcinoma treated with the anti-vascular endothelial growth factor receptor sunitinib and showing marked long-term clinical response. Through this case, we highlight the importance of re-classifying papillary renal cell carcinoma subtypes to prioritize the clinical management of these cases.
在过去几十年中，成人肾细胞癌的发病率在男性和女性中均呈上升趋势。根据最新的癌症统计报告，曾经发病率为2.9%，现在据报道已增至3%-5%，且男性占主导。该疾病通常描述的是一组不同的组织病理学亚型；最常见的是透明细胞癌，占确诊病例的70%-80%，而乳头状肾细胞癌和嫌色细胞类型分别占20%和5%。1996年，Delahunt等人引入了肾细胞癌海德堡分类法。它将肾细胞肿瘤分为良性和恶性实质肿瘤，不包括威尔姆斯瘤和继发性转移瘤，并在适用的情况下将每个亚类限制为最常见的记录在案的基因异常。在本报告中，我们讨论了一例转移性I型乳头状肾细胞癌病例，该病例接受抗血管内皮生长因子受体舒尼替尼治疗并显示出显著的长期临床反应。通过这个病例，我们强调了重新分类乳头状肾细胞癌亚型以优先处理这些病例临床管理的重要性。
