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Presented by Dr. Andres Matoso and prepared by Dr. Katherine Fomchenko.
This case is an adult female with a renal mass.
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1. Question
This case is an adult female with a renal mass.
Correct
Answer: C. Renal carcinoid tumor
Histology: The lesion is a generally well-defined nodule within the kidney with focal areas of infiltrative growth at the edge of the nodule. The monotonous neoplastic cells have a nested and trabecular growth pattern and nuclei with finely speckled “salt and pepper” chromatin typical of neuroendocrine neoplasms.
Discussion: Neuroendocrine neoplasms of the kidney are rare tumor that can behave more aggressively than carcinoid tumors originating from other sites, with a high rate of recurrence at the site of resection and metastasis to other sites. In one case study of this entity, 24% of patients with this tumor had a horseshoe kidney. Immunostains for neuroendocrine markers such as synaptophysin and chromogranin A will be positive. Case reports of the tumor show that many express somatostatin receptors, raising the possibility of using somatostatin analogues as an adjuvant treatment.
Hansel DE, Epstein JI, Berbescu E, Fine SW, Young RH, Cheville JC.. Renal carcinoid tumor: a clinicopathologic study of 21 cases. Am J Surg Pathol. 2007 Oct;31(10):1539-44
McGarrah PW, Westin GFM, Hobday TJ, Scales JA, Ingimarsson JP, Leibovich BC, Halfdanarson TR. Renal Neuroendocrine Neoplasms: A Single-center Experience. Clin Genitourin Cancer. 2020 Aug;18(4):e343-e349. doi: 10.1016/j.clgc.2019.11.003. Epub 2019 Dec 5. PMID: 31911122.
Incorrect
Answer: C. Renal carcinoid tumor
Histology: The lesion is a generally well-defined nodule within the kidney with focal areas of infiltrative growth at the edge of the nodule. The monotonous neoplastic cells have a nested and trabecular growth pattern and nuclei with finely speckled “salt and pepper” chromatin typical of neuroendocrine neoplasms.
Discussion: Neuroendocrine neoplasms of the kidney are rare tumor that can behave more aggressively than carcinoid tumors originating from other sites, with a high rate of recurrence at the site of resection and metastasis to other sites. In one case study of this entity, 24% of patients with this tumor had a horseshoe kidney. Immunostains for neuroendocrine markers such as synaptophysin and chromogranin A will be positive. Case reports of the tumor show that many express somatostatin receptors, raising the possibility of using somatostatin analogues as an adjuvant treatment.
Hansel DE, Epstein JI, Berbescu E, Fine SW, Young RH, Cheville JC.. Renal carcinoid tumor: a clinicopathologic study of 21 cases. Am J Surg Pathol. 2007 Oct;31(10):1539-44
McGarrah PW, Westin GFM, Hobday TJ, Scales JA, Ingimarsson JP, Leibovich BC, Halfdanarson TR. Renal Neuroendocrine Neoplasms: A Single-center Experience. Clin Genitourin Cancer. 2020 Aug;18(4):e343-e349. doi: 10.1016/j.clgc.2019.11.003. Epub 2019 Dec 5. PMID: 31911122.
