Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2024; 12(22): 5124-5130
Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.5124
Eosinophilic solid and cystic renal cell carcinoma with aggressive behavior: Two case reports
Hui-Hui Cao, Hong Li, Xiao-Hong Guo, Zhi-Xing Cao, Bo-Hui Zhang
Hui-Hui Cao, Hong Li, Xiao-Hong Guo, Zhi-Xing Cao, Bo-Hui Zhang, Department of Pathology, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai 519000, Guangdong Province, China
Author contributions: Cao ZX and Guo XH made the final pathological diagnosis; Zhang BH performed immunohistochemical studies and analyzed the molecular data; Cao HH, Li H summarized the pathological and clinical data, organized the study and wrote the manuscript. All authors have read and approved the final manuscript.
Informed consent statement: Informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo-Hui Zhang, BM BCh, Technician, Department of Pathology, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), No. 79 Kangning Road, Zhuhai 519000, Guangdong Province, China. 412338793@qq.com
Received: February 3, 2024
Revised: May 29, 2024
Accepted: June 17, 2024
Published online: August 6, 2024
Processing time: 149 Days and 21.7 Hours
Abstract
BACKGROUND

Eosinophilic solid and cystic (ESC) renal cell carcinoma (RCC), a unique and emerging subtype of RCC, has an indolent nature; in some rare instances, it may exhibit metastatic potential. Current cases are inadequate to precisely predict the clinical outcome of ESC RCC and determine treatment choices.

CASE SUMMARY

Herein, we report two patients with ESC RCC. Patient 1 was a young woman with classical pathological characteristics. Patient 2 was a 52-year-old man with multifocal metastases, involving the pulmonary hilar and mediastinal lymph nodes, liver, brain, mesosternum, vertebra, rib, femur, and symphysis pubis. Awareness of ESC RCC, along with its characteristic architecture and immunophenotype, would contribute to making a definitive diagnosis, even on core biopsy samples.

CONCLUSION

The discovery of ESC RCC molecular signatures may provide new therapeutic strategies in the future.

Keywords: Eosinophilic solid and cystic renal cell carcinoma, Solid and cystic growth pattern, CK20, TSC1 mutations, TSC2 mutations, Case report

Core Tip: Most patients with eosinophilic solid and cystic (ESC) renal cell carcinoma (RCC) have an indolent nature, but 8 cases have exhibited metastatic potential. In this study, we made a clear diagnosis in 2 cases of ESC RCC, including a case with multifocal metastases, by pathological microscopy, immunohistochemistry, next-generation sequencing, or whole exome sequencing analysis, which played a crucial role in clinical treatment. Usually, ESC RCC has a solid and cystic growth pattern, a voluminous eosinophilic cytoplasm with coarse basophilic stippling, is CK20 positive and has TSC1/2 mutations.