1/36. Scintigraphic demonstration of renal cell carcinoma with I-131-6beta-iodomethyl-19-norcholesterol: a case report.Extraadrenal abnormal uptake on adrenocortical scintigraphy has been reported rarely in the normal gallbladder, lipid cell tumor of the ovary, or in clear cell type renal cell carcinoma. Clear cell type renal cell carcinoma contains glycogen and cholesterol like the adrenal gland, but the uptake of the radionuclide I-131 cholesterol has been reported to be low and not sufficient to image it. Right renal and adrenal masses were incidentally discovered on abdominal CT scan in a patient with chronic renal failure resulting in bilateral acquired cystic kidney disease. Adrenocortical scintigraphy done to know the nature of the adrenal mass showed high uptake corresponding to the right renal mass and the right adrenal mass. Clear cell type renal cell carcinoma and adrenal adenoma with prominent clear cells were histologically confirmed on hematoxylin-eosin stain and in an immunohistochemical study with renal cell antibody. Not only low-density lipoprotein receptors mediated uptake but also overall replacement of the right non-tumorous renal parenchyma by acquired cysts may have played a role in imaging the renal cell carcinoma on adrenocortical scintigraphy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/36. Giant renal oncocytoma.We report the largest renal oncocytoma excised at the initial presentation and the second largest renal oncocytoma in published reports. Despite a tendency for renal oncocytomas to be relatively small and asymptomatic compared with renal cell carcinomas, these lesions cannot be reliably differentiated preoperatively. The variable nature of presentation and overlap of radiographic characteristics between these lesions complicates their clinical differentiation. The present case illustrates the difficulty in the preoperative diagnosis of even very large, enhancing renal masses and reinforces the inclusion of renal oncocytoma in the differential diagnosis of these lesions.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/36. splenosis mimicking tumor recurrence in renal cell carcinoma: detection on selective spleen scintigraphy.A 2-year-old boy had been operated on for a giant renal cell carcinoma including splenectomy because of disrupture of the splenic capsule. During a follow-up examination, 3 nodules were detected by ultrasound in the splenorenal area. This gave reason to suspect tumor recurrence. Considering the possibility of splenosis, a selective spleen scan using denatured red blood cells was performed as a final diagnostic step. This method confirmed the nodules as representing splenic tissue. splenosis should be included in the differential diagnosis of solid masses in the postsplenectomy patient.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/36. Low-grade renal cell carcinoma arising from the lower nephron: a case report with immunohistochemical, histochemical and ultrastructural studies.Most renal cell carcinomas (RCC) are composed of clear cells with sinusoid-like vasculatures and originate from the proximal tubule. On the other hand, collecting duct carcinoma (CDC) and chromophobe RCC are thought to originate from the lower nephron. In the present study, we present a case of unusual RCC. The patient was a 68-year-old Japanese woman who had developed general fatigue with hematuria. Computed tomography revealed a left renal tumor suggesting sarcoma. The resected tumor was located in the renal parenchyma, measuring 12 x 10 x 8 cm in size. Histologically, the tumor consisted principally of cuboidal cells forming parallel or radiating arrays, continuous with the spindle-shaped cells. Most parts of the tumor showed hemorrhagic necrosis. Immunohistochemically, tumor cells were positive for high molecular weight cytokeratins, vinculin, vimentin, CD15 and epithelial membrane antigen, and showed affinities with some kinds of lectins. N- and E-cadherins and beta-catenin were diffusely positive in tumor cells. Nuclear positivity for Ki-67 and p53 protein were approximately 2.0 and 1.7%, respectively. Considering its morphological and histochemical natures, this tumor is considered to have originated from the lower nephron, which is unique for a tumor of low-grade malignancy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/36. High intensity focused ultrasound as noninvasive therapy for multilocal renal cell carcinoma: case study and review of the literature.PURPOSE: Noninvasive tumor ablation can be achieved by extracorporeally induced high intensity focused ultrasound. Clinical high intensity focused ultrasound performed to date for renal tumors have only been experimental in nature. We present specific details on a patient with renal cell carcinoma who underwent high intensity focused ultrasound with curative intent and long-term followup examinations. MATERIALS AND methods: Ultrasound waves were generated by a cylindrical piezoelectric element focused by a paraboloid reflector. High intensity focused ultrasound was applied to 3 tumors in 3 sessions with the patient under general anesthesia or sedation analgesia, followed by magnetic resonance imaging for 6 months. RESULTS: After treatment magnetic resonance imaging showed necrosis in the 2 tumors in the lower kidney pole within 17 and 48 days, respectively. The necrotic tumor area shrank thereafter within 6 months. The tumor in the upper pole was not affected by treatment due to absorption of the ultrasound energy by the interposed ribs. General anesthesia was required to apply high energy levels of focused ultrasound. absorption of high intensity focused ultrasound in the tissue induced sharply demarcated thermonecrosis. For 50 years patients have been treated with high intensity focused ultrasound for different indications, focusing on the brain, eyes, prostate, liver and bladder. For the kidney experimental but only few clinical studies indicate sufficient tissue ablation. CONCLUSIONS: In our case contactless noninvasive application of high intensity focused ultrasound to 2 renal carcinomas achieved thermal ablation. When high intensity focused ultrasound energy was coupled correctly, no lesions occurred outside of the target area. Successful high intensity focused ultrasound application depended on optimum energy coupling, a sufficiently high ultrasound energy level and general anesthesia.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/36. Long-term management of bilateral metastases of renal cell carcinoma to the choroid plexus.BACKGROUND: Metastatic tumors to the brain presenting exclusively in the choroid plexus are exceedingly rare. These events are frequently associated with renal cell carcinoma (RCC), of which all reported cases have been solitary lesions. methods: The authors present the unusual case of a patient with metastatic RCC who developed bilateral tumors of the choroid plexus. These tumors, one of which was confirmed to be metastatic RCC by histologic analysis, were treated over a 5-year period with a combination of interventions, including surgical resection, stereotactic radiosurgery, and chemotherapy, in conjunction with continual radiological monitoring. FINDINGS: Follow-up over a 5-year period demonstrated good control of the patient's intracranial disease and very little neurologic sequelae. INTERPRETATION: This strategy was successful in keeping the patient in good health with minimal neurological symptoms, despite the bilateral nature of the disease and its generally poor prognosis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/36. Synchronous bilateral renal tumour: a case report.We report a case of synchronous bilateral renal carcinoma treated by partial nephrectomy on the right and total nephrectomy on the left. Follow-up at 42 months after surgery showed no recurrence of the disease. The increasing use of diagnostic imaging techniques such as ultrasound tomography, computerised tomography and nuclear magnetic resonance now allows even small-sized renal formations to be identified. Synchronous bilateral renal tumour has a favourable prognosis, especially when compared with single or asynchronous renal tumours. The recommended intervention is total monolateral nephrectomy combined with partial nephrectomy. The treatment of neoplasms at a more advanced stage, of such a nature as to necessitate bilateral nephrectomy or chemotherapy, results in a significant increase in mortality. Recently, biological therapy has been proposed as a more promising short-term option using interferon-alpha (IFN-alpha) and gamma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/36. Laser navigation for radiofrequency ablation.A 45-year-old male with renal cell carcinoma secondary to von-Hippel Lindau (VHL) disease presented for radiofrequency ablation (RFA) of kidney tumors. Due to his prior history of several partial nephrectomies and limited renal reserve, RFA was chosen because of its relatively nephron-sparing nature. A laser guidance device was used to help guide probe placement in an attempt to reduce procedure time and improve targeting accuracy. The device was successful at guiding needle placement, as both tumors were located with a single pass. Follow-up CT scan confirmed accurate needle placement, showing an area of coagulation necrosis covering the previously seen tumor.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/36. Inflammatory pseudotumor of the spleen concomitant with renal cell carcinoma: case report.CONTEXT: Inflammatory pseudotumor is a rare benign lesion that can occur at a wide variety of primary sites. It is usually worrisome for the patient and the medical staff, since it cannot be clinically or radiologically distinguished from malignant entities. CASE REPORT: We report on a case of splenic inflammatory pseudotumor presenting with concomitant renal cell carcinoma. Despite the alarming macroscopic appearance of pseudotumors, their microscopic features usually confirm the inflammatory nature of such lesions. Evidence regarding the etiology of pseudotumors is still lacking, but hypotheses have been created.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/36. von hippel-lindau disease and renal cell carcinoma in a 16-year-old boy.von hippel-lindau disease is a rare autosomal dominant disorder. kidney lesions occur in the majority of cases, with renal cell carcinoma noted in 40% and renal cysts in 60%. Renal cell carcinoma in von hippel-lindau disease is usually bilateral and occurs at an earlier age than in patients with sporadic renal cell carcinoma. We report on a 16-year-old boy who, to our knowledge, is the youngest patient to present with von hippel-lindau disease and renal cell carcinoma. Controversy currently exists regarding the nature of renal cysts in von hippel-lindau disease and the optimal therapeutic approach (that is radical versus parenchymal sparing surgery). We review the histology of renal cysts and carcinoma, and discuss the rationale for selecting parenchymal sparing surgery.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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