Detection of two synchronous histologically different renal cell carcinoma subtypes in the same kidney: a case report and review of the literature

J Med Case Rep. 2024 May 18;18(1):250. doi: 10.1186/s13256-024-04527-x.

Abstract

Introduction: Renal cell carcinoma (RCC) is the dominant primary renal malignant neoplasm, encompassing a significant portion of renal tumors. The presence of synchronous yet histologically distinct ipsilateral RCCs, however, is an exceptionally uncommon phenomenon that is rather under-described in the literature regarding etiology, diagnosis, management, and later outcomes during follow-up.

Case presentation: We aim to present the 9th case of a combination chromophobe RCC (ChRCC) and clear cell RCC (ccRCC) in literature, according to our knowledge, for a 69-year-old North African, Caucasian female patient who, after complaining of loin pain and hematuria, was found to have two right renal masses with preoperative computed tomography (CT) and underwent right radical nephrectomy. Pathological examination later revealed the two renal masses to be of different histologic subtypes.

Conclusion: The coexistence of dissimilar RCC subtypes can contribute to diverse prognostic implications. Further research should focus on enhancing the complex, yet highly crucial, preoperative detection and pathological examination to differentiate multiple renal lesions. Planning optimal operative techniques (radical or partial nephrectomy), selecting suitable adjuvant regimens, and reporting long-term follow-up outcomes of patients in whom synchronous yet different RCC subtypes were detected are of utmost importance.

Keywords: Case report; Chromophobe renal cell carcinoma (ChRCC); Clear cell renal cell carcinoma (ccRCC); Different histology; Synchronous renal cell carcinoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Carcinoma, Renal Cell* / diagnosis
  • Carcinoma, Renal Cell* / diagnostic imaging
  • Carcinoma, Renal Cell* / pathology
  • Carcinoma, Renal Cell* / surgery
  • Female
  • Humans
  • Kidney Neoplasms* / diagnosis
  • Kidney Neoplasms* / diagnostic imaging
  • Kidney Neoplasms* / pathology
  • Kidney Neoplasms* / surgery
  • Neoplasms, Multiple Primary* / diagnosis
  • Neoplasms, Multiple Primary* / diagnostic imaging
  • Neoplasms, Multiple Primary* / pathology
  • Neoplasms, Multiple Primary* / surgery
  • Nephrectomy*
  • Tomography, X-Ray Computed*