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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2020; 12(6): 298-306
Published online Jun 27, 2020. doi: 10.4240/wjgs.v12.i6.298
Cystic low-grade collecting duct renal carcinoma with liver compression — A challenging diagnosis and therapy: A case report
Zsolt Zoltan Fulop, Simona Gurzu, Ioan Jung, Patricia Simu, Laura Banias, Emoke Fulop, Emoke Dragus, Tivadar Jr Bara
Zsolt Zoltan Fulop, Tivadar Jr Bara, Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures 540139, Romania
Simona Gurzu, Ioan Jung, Laura Banias, Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures 540139, Romania
Simona Gurzu, Emoke Fulop, Department of Pathology, Clinical County Emergency Hospital, Targu Mures 540067, Romania
Patricia Simu, Department of Radiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures 540139, Romania
Emoke Dragus, Department of Urology, Clinical County Hospital, Targu Mures 540167, Romania
Author contributions: Fulop ZZ participated in the surgical intervention, analyzed the case and drafted the article; Gurzu S performed the histological diagnosis and contributed to the study design; Jung I contributed to the interpretation of immunohistochemical stains; Simu P performed the radiological examinations and provided the imagistic figures; Banias L participated in the histopathological examinations and assessment of histological images; Fulop E participated in the histological and immunohistochemical assessment of the case; Dragus E searched the literature and was involved in patient follow-up; Bara TJ performed the surgical intervention and provided final agreement for publication.
Supported by the Collegium Talentum 2019 Program of Hungary.
Informed consent statement: Signed consent was obtained from the patient. The patient also signed the legal consent regarding the surgical treatment, the use of his personal data for scientific purposes, for photography and filming, respectively.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Simona Gurzu, MD, PhD, Chief Doctor, Full Professor, Research Fellow, Research Scientist, Consultant Pathologist, Director of Department of Pathology, Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gheorghe Marinescu Street, Targu Mures 540139, Romania. simonagurzu@yahoo.com
Received: February 6, 2020
Peer-review started: February 6, 2020
First decision: March 29, 2020
Revised: April 6, 2020
Accepted: May 12, 2020
Article in press: May 12, 2020
Published online: June 27, 2020
BACKGROUND
A collecting duct carcinoma is a very rare, malignant renal epithelial tumor. Distant metastases are present in one third of cases at the time of diagnosis. It is known to have a poor prognosis.
CASE SUMMARY
A 42-year-old male was sent to our surgery clinic for removal of a 119.2 mm × 108.3 mm encapsulated cystic mass, which was localized in the 8th segment of the right liver lobe. The lesion was first identified on ultrasonography. A computed tomography scan confirmed the presence of a Bosniak type III cystic lesion, which affected the liver and convexity of the right kidney. Surgical intervention involved a right nephrectomy, with removal of the cystic mass. The patient was mobilized on the first postoperative day and was discharged after 7 d. The histological and immunohistochemical examination revealed a low-grade collecting duct renal carcinoma, which is a rare variant of papillary carcinoma, with low malignant potential. The patient did not receive chemotherapy and after 21 mo of follow-up, a radiological examination and laboratory analyses showed normal aspects. No relapse or other complications were reported.
CONCLUSION
To manage renal tumors properly, a correct histopathological diagnosis is crucial, as is early diagnosis and correct surgical treatment.
Core tip: We present a patient with a rare histological variant of renal carcinoma. There are at least three particularities related to this tumor. Firstly, during imaging investigations, renal carcinoma mimics an encapsulated cyst. Secondly, the differential diagnosis was difficult and was finally established by immunohistochemical staining. Thirdly, although collecting duct carcinoma is known to have an aggressive behavior, the histological assessment indicated a low-grade carcinoma. The patient is still alive after 21 mo of regular follow-up, without postoperative oncological therapy.
