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Rare Malignancies of the Kidney: Evaluation and Management

  • Chapter
Clinical Management of Renal Tumors

Abstract

Up to twenty percent of renal masses suspicious for renal cell carcinoma in adults are not RCC upon final pathology. While many of these tumors are benign, those that are malignant tend to be aggressive and lethal. Rare malignancies can often be diagnosed with renal biopsy. Many of these malignancies require additional or alternative oncologic therapies and close collaboration with medical and/or radiation oncologists. This chapter reviews the pathologic, diagnostic, therapeutic, including surgical and non-surgical approaches, and prognostic considerations pertaining to these uncommon renal malignancies. Covered are renal sarcoma, renal lymphoma, metastatic disease, carcinoid adult Wilms’ tumor, primitive neuroendocrine tumor, and small cell carcinoma.

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References

  1. Silver DA, Morash C, Brenner P, et al. Pathologic findings at the time of nephrectomy for renal mass. Ann Surg Oncol 1997;4:570–574.

    Article  PubMed  CAS  Google Scholar 

  2. Russo P, Brady MS, Conlon K, et al. Adult urological sarcoma. J Urol 1992;147:1032–1037.

    PubMed  CAS  Google Scholar 

  3. Frank I, Takahashi S, Tsukamoto T, Lieber MM. Genitourinary sarcomas and carcinosarcomas in adults. In: Vogelzang NJ, ed. Comprehensive Textbook of Genitourinary Oncology, 2nd ed. Philadelphia: Lippincott Williams & Wilkins.

    Google Scholar 

  4. Vogelzang NJ, Fremgen AM, Guinan PD, et al. Primary renal sarcoma in adults: a natural history and management study by the American cancer society, Illinois division. Cancer 1993;71:804–810.

    CAS  Google Scholar 

  5. Brennan MF, Alektiar KM, Maki RG. Soft tissue sarcoma. In: Devita ET, ed. Cancer: Principles and Practice of Oncology, 6th ed. Philadelphia: Lippincott Williams & Wilkins.

    Google Scholar 

  6. Froehner M, Lossnitzer A, Manseck A, et al. Favorable long-term outcome in adult genitourinary low-grade sarcoma. Urology 2000;56:373–377.

    Article  PubMed  CAS  Google Scholar 

  7. Spellman JE, Driscoll DL, Huben RP. Primary renal sarcoma. Amer Surg 1995;61:456–459.

    Google Scholar 

  8. American Joint Committee on Cancer. Soft tissue sarcoma. In: Greene FL, Page DL, Fleming ID, et al., eds. AJCC Cancer Staging Handbook, 6th ed. New York: Springer.

    Google Scholar 

  9. Moudouni SM, En-Nia I, Rioux-Leclerq N, et al. Leiomyosarcoma of the renal pelvis. Scand J Urol Nephrol 2001;35:425–427.

    Article  PubMed  CAS  Google Scholar 

  10. Gill IS, Hobart MG, Kaouk JH, et al. Leiomyosarcoma of the main renal artery treated by laparoscopic radical nephrectomy. Urology 2000;56:669x–669xi.

    Article  Google Scholar 

  11. Deyrup AT, Montogomery E, Fisher C. Leiomyosarcoma of the kidney: a clinicopathologic study. Am J Surg Pathol 2004;28:178–182.

    Article  PubMed  Google Scholar 

  12. Novick AC, Cambell SC. Renal Tumors. In: Walsh PC, ed. Campbell’s Urology, 8th ed. Philadelphia: Saunders.

    Google Scholar 

  13. Pollack HM, Banner MP, Amendola MA. Other malignant neoplasms of the renal parenchyma. Semin Roentgenol 1987;22:260–274.

    Article  PubMed  CAS  Google Scholar 

  14. Cerilli LA, Huffman HT, Anand A. Primary renal angiosarcoma: a case report with immunohistochemical, ultrastructural and cytogenetic features and review of the literature. Arch Pathol Lab Med 1998;122:929–935.

    PubMed  CAS  Google Scholar 

  15. Weiss JP, Pollack HM, McCormick JF, et al. Renal hemangiopericytoma: surgical radiological and pathological implications. J Urol 1984;132:337–339.

    PubMed  CAS  Google Scholar 

  16. Merchant SH, Mittal BV, Desai MS. Haemangiopericytoma of kidney: a report of 2 cases. J Postgrad Med 1998;44:78–80.

    PubMed  CAS  Google Scholar 

  17. Chieng D, Cohen JM, Waisman J. Fine-needle aspiration cytology of hemangiopericytoma: a report of five cases. Cancer 1999;87:190–195.

    Article  Google Scholar 

  18. Raghavaiah NV, Mayer RF, Hagitt R, et al. Malignant fibrous histiocytoma of the kidney. J Urol 1979;123:951–953.

    Google Scholar 

  19. Chen CH, Lee PS, Han WJ, et al. Primary giant cell malignant fibrous histiocytoma of the kidney with staghorn calculi. J Postgrad Med 2003;49:246–248.

    PubMed  CAS  Google Scholar 

  20. Bella AJ, Winquist EW, Perlman EJ. Primary synovial sarcoma of the kidney diagnosed by molecular detection of syt-ssx fusion transcripts. J Urol 2002;168:1092–1093.

    Article  PubMed  Google Scholar 

  21. Koyama S, Morimitsu Y, Morokuma F. Primary synovial sarcoma of the kidney: report of a case confirmed by molecular detection of the syt-ssx fusion transcripts. Pathol Int 2001;51:385–391.

    Article  PubMed  CAS  Google Scholar 

  22. Leventis AK, Stathopoulos GP, Boussiotou AC, et al. Primary osteogenic sarcoma of the kidney: a case report and review of the literature. Acta Oncol 1997;36:775–777.

    Article  PubMed  CAS  Google Scholar 

  23. Barnard M, Bayani J, Grant R, et al. Comparative genomic hybridization analysis of clear cell sarcoma of the kidney. Med Pediatr Oncol 2000;24:113–116.

    Article  Google Scholar 

  24. Argani P, Perlman EJ, Breslow NE, et al. Clear cell sarcoma of the kidney: a review of 351 cases from the national Wilms’ tumor study group pathology center. Am J Surg Pathol 2000;24:4–18.

    Article  PubMed  CAS  Google Scholar 

  25. Delahunt B, Beckwith JB, Eble JN, et al. Cystic embryonal sarcoma of the kidney: a case report. Cancer 1998;82:2427–2433.

    Article  PubMed  CAS  Google Scholar 

  26. Shirkhoda A, Lewis E. Renal sarcoma and sarcomatoid renal cell carcinoma: CT and angiographic features. Radiology 1987;162:252–257.

    Google Scholar 

  27. Vesoulis Z, Rameh T, Nelson R, et al. Fine needle aspiration biopsy of primary renal synovial sarcoma: a case report. Acta Cytol 2003;47:668–672.

    PubMed  Google Scholar 

  28. Johnson VV, Gaertner EM, Crothers BA. Fine-needle aspiration of renal angiosarcoma. Arch Pathol Lab Med 2002;126:478–480.

    PubMed  Google Scholar 

  29. Tepper JE, Suit HD, Wood WC, et al. Radiation therapy of retroperitoneal soft tissue sarcomas. Int J Radiat Oncol Biol Phys 1984;10:825.

    PubMed  CAS  Google Scholar 

  30. Kandel LB, McCullough DL, Harrison LH, et al. Primary renal lymphoma: does it exist? Cancer 1987;60:386–391.

    Article  PubMed  CAS  Google Scholar 

  31. Yasunaga Y, Hoshida Y, Hashimoto M, et al. Malignant lymphoma of the kidney. J Surg Oncol 1997;64:207–211.

    Article  PubMed  CAS  Google Scholar 

  32. Dimopoulos MA, Moulopoulos LA, Costantinides C, et al. Primary renal lymphoma: a clinical and radiological study. J Urol 1996;155:1865–1867.

    Article  PubMed  CAS  Google Scholar 

  33. O’Riordan E, Reeve R, Houghton JB, et al. Primary bilateral T-cell renal lymphoma presenting with sudden loss of renal function. Nephrol Dial Transplant 2001;16:1487–1489.

    Article  PubMed  Google Scholar 

  34. Tuzel E, Mungan M, Yorukoglu K, et al. Primary renal lymphoma of mucosa-associated lymphoid tissue. Urology 2003;61:463xvii–463xx.

    Article  Google Scholar 

  35. Urban BA, Fishman EK. Renal lymphoma: CT patterns with emphasis on helical CT. Radiographics 2000;20:197–212.

    PubMed  CAS  Google Scholar 

  36. Choi JH, Choi GB, Shim KN, et al. Bilateral primary renal non-Hodgkin’s lymphoma presenting with acute renal failure: successful treatment with systemic chemotherapy. Acta Haematol 1997;97:231–235.

    Article  PubMed  CAS  Google Scholar 

  37. Jafri SZH, Bree RL, Amendola MA, et al. CT of renal and perirenal non-Hodgkin lymphoma. AJR 1982;138:1101–1105.

    PubMed  CAS  Google Scholar 

  38. Sheeran SR, Sussman SK. Renal lymphoma: spectrum of CT findings and potential mimics. AJR 1998;171:1067–1072.

    PubMed  CAS  Google Scholar 

  39. Semelka RC, Kelekis NL, Burdeny DA, et al. Renal lymphoma: demonstration by MR imaging. AJR 1996;166:823–827.

    PubMed  CAS  Google Scholar 

  40. Armitage JO, Mauch PM, Harris NL, Bierman P. Non-Hodgkins’ lymphomas. In: Devita ET, ed. Cancer: Principles and Practice of Oncology, 6th ed. Philadelphia: Lippincott Williams & Wilkins.

    Google Scholar 

  41. Taniguchi M, Higashi K, Ohguchi M, et al. Gallium-67 citrate scintigraphy of primary renal lymphoma. Ann Nucl Med 1998;12:51–53.

    Article  PubMed  CAS  Google Scholar 

  42. Truong LD, Caraway N, Ngo T, et al. The diagnostic and therapeutic roles of fine-needle aspiration. Am J Clin Pathol 2001;115:18–31.

    Article  PubMed  CAS  Google Scholar 

  43. Colevas Ad, Kantoff PW, DeWolf WC, Canellos GP. Malignant lymphoma of the genitourinary tract. In: Vogelzang NJ, ed. Comprehensive Textbook of Genitourinary Oncology, 2nd ed. Philadelphia: Lippincott Williams & Wilkins.

    Google Scholar 

  44. Okuno SH, Hoyer JD, Ristow K, et al. Primary renal non-Hodgkin’s lymphoma: an unusual extranodal site. Cancer 1995;75:2258–2261.

    Article  PubMed  CAS  Google Scholar 

  45. Arranz-Arija JA, Carrion JR, Garcia FR, et al. Primary renal lymphoma: report of 3 cases and review of the literature. Am J Nephrol 1994;14:148–153.

    Article  PubMed  CAS  Google Scholar 

  46. Sanchez-Ortiz RF, Madsen LT, Bermejo CE, et al. A renal mass in the setting of a nonrenal malignancy: when is a renal tumor biopsy appropriate? Cancer 2004;101:2195–2201.

    Article  PubMed  Google Scholar 

  47. Olsson CA, Moyer JD, Laferte RO. Pulmonary cancer metastatic to the kidney: a common renal neoplasm. J Urol 1971;105:492–496.

    PubMed  CAS  Google Scholar 

  48. Ferrozzi F, Bova D, Campodonico F. Computed tomography of renal metastases. Semin Ultrasound CT MR 1997;18:115–121.

    Article  PubMed  CAS  Google Scholar 

  49. Walther PJ, Marks LS, Stern D, et al. Renal metastasis of adenocarcinoma of the lung: massive hematuria managed by therapeutic embolization. J Urol 1979:398–400.

    Google Scholar 

  50. Choyke PL, White EM, Zeman RK, et al. Renal metastases: clinicopathologic and radiologic correlation. Radiology 1987;162:359–363.

    PubMed  CAS  Google Scholar 

  51. Manning EC, Belenko MI, Frauenhoffer EE, et al. Acute renal failure secondary to solid tumor renal metastases: case report and review of the literature. Am J Kidney Dis 1996;27:284–291.

    Article  PubMed  CAS  Google Scholar 

  52. Kawajiri H, Onoda N, Ohira M, et al. Carcinoid tumor of the kidney presenting as a large abdominal mass: report of a case. Surg Today 2004;34:86–89.

    Article  PubMed  Google Scholar 

  53. Krishnan B, Truong LD, Saleh G, et al. Horseshoe kidney is associated with an increased relative risk of primary renal carcinoid tumor. J Urol 1997;157:2059–2066.

    Article  PubMed  CAS  Google Scholar 

  54. Begin LR, Guy L, Jacobson SA, et al. Renal carcinoid and horseshoe kidney: a frequent association of two rare entities—a case report and review of the literature. J Surg Onc 1998;68:113–119.

    Article  CAS  Google Scholar 

  55. Kulke MH, Mayer RJ. Carcinoid tumors. N Engl J Med 1999;340:858–868.

    Article  PubMed  CAS  Google Scholar 

  56. Jensen RT, Doherty GM. Carcinoid tumors and the carcinoid syndrome. In: Devita ET, ed. Cancer: Principles and Practice of Oncology, 6th ed. Philadelphia: Lippincott Williams & Wilkins.

    Google Scholar 

  57. Moulopoulos A, DuBrow R, Dimopoulos DC. Primary renal carcinoid: computed tomography, ultrasound and angiographic findings. J Comput Assist Tomogr 1991;15:323–325.

    Article  PubMed  CAS  Google Scholar 

  58. McCaffrey JA, Reuter V, Herr HW, et al. Carcinoid tumor of the kidney. The use of somatostatin receptor scintigraphy in diagnosis and management. Urol Oncol 2000;5:108–111.

    Article  PubMed  Google Scholar 

  59. Tal R, Lask DM, Livne PM. Metastatic renal carcinoid: case report and review of the literature. Urology 2003;61:838xv–838xvii.

    Article  Google Scholar 

  60. Kilton L, Matthews MJ, Cohen MH. Adult Wilms’ tumor: a report of prolonged survival and review of the literature. J Urol 1980;124:1–5.

    PubMed  CAS  Google Scholar 

  61. Winter P, Vahlnensieck W, Miersch WDE, et al. Wilms’ tumor in adults. Review of 10 cases. Int Urol Nephrol 1996;28:469–475.

    Article  PubMed  CAS  Google Scholar 

  62. Orditura M, De Vita F, Catalano G. Adult Wilms’ tumor: a case report. Cancer 1997;15:1961–1965.

    Article  Google Scholar 

  63. Rubin BP, Pins MR, Nielsen GP, et al. Isochromosome 7q in adult Wilms’ tumors: diagnostic and pathogenetic implications. Am J Surg Pathol 2000;24:1663–1669.

    Article  PubMed  CAS  Google Scholar 

  64. Firoozi F, Kogan BA. Follow-up and management of recurrent Wilms’ tumor. Urol Clin North Am 2003;30:869–879.

    Article  PubMed  Google Scholar 

  65. Reinhard H, Aliani S, Ruebe C, et al. Wilms’ tumor in adults: results of the society of pediatric oncology (SIOP) 93-01/society for pediatric oncology and hematology (GPOH) study. J Clin Oncol 2004;22:4500–4506.

    Article  PubMed  Google Scholar 

  66. Akmansu M, Yapici T, Tulay E. Adult Wilms’ tumor: a report of two cases and their treatment and prognosis. Int Urol Nephrol 1998;30:529–533.

    Article  PubMed  CAS  Google Scholar 

  67. Green DM. Paediatric oncology update: Wilms’ tumor. European Journal of Cancer 1997;33: 409–418.

    Article  PubMed  CAS  Google Scholar 

  68. Neville HL, Ritchey ML. Wilms’ tumor: overview of national Wilms’ tumor study group results. Urol Clin North Am 2000;27:443–454.

    Article  Google Scholar 

  69. Bozeman G, Bissada NK, Abboud MR, et al. Adult Wilms’ tumor: prognostic and management considerations. Urology 1995;45:1055–1058.

    Article  PubMed  CAS  Google Scholar 

  70. Terenziani M, Spreafico F, Collini P, et al. Adult Wilms’ tumor: a monoinstitutional experience and a review of the literature. Cancer 2004;101:289–293.

    Article  PubMed  Google Scholar 

  71. Maly B, Maly A, Reinhartz T, et al. Primitive neuroectodermal tumor of the kidney: report of a case initially diagnosed by fine needle aspiration cytology. Acta Cytol 2004;48:264–268.

    PubMed  Google Scholar 

  72. Jimenez RE, Folpe AL, Lapham RL, et al. Primary Ewing’s sarcoma/primitive neuroectodermal tumor of the kidney: a clinicopathologic and immunohistochemical analysis of 11 cases. Am J Surg Pathol 2002;26:320–327.

    Article  PubMed  Google Scholar 

  73. Ginsberg JP, Woo SY, Johnson ME, et al. Ewing’s sarcoma family of tumors: Ewing’s sarcoma of bone and soft tissue and the peripheral primitive neuroectodermal tumors. In: Devita ET, ed. Cancer: Principles and Practice of Oncology, 6th ed. Philadelphia: Lippincott Williams & Wilkins.

    Google Scholar 

  74. Parham DM, Roloson GJ, Feely M, et al. Primary malignant neuroepithelial tumors of the kidney. Am J of Surg Pathol 2001;28:133–146.

    Article  Google Scholar 

  75. Pomara G, Capello F, Cuttano MG, et al. Primitive neuroectodermal tumor (PNET) of the kidney: a case report. BMC Cancer 2004;4:3.

    Article  PubMed  Google Scholar 

  76. Rodriquez-Galindo C, Marina NM, Fletcher BD, et al. Is primitive neuroectodermal tumor of the kidney a distinct entity? Cancer 1997;79:2243–2250.

    Article  Google Scholar 

  77. Doerfler O, Reittner P, Groell R, et al. Peripheral primitive neuroectodermal tumour of the kidney: CT findings. Pediatr Radiol 2001;31:117–119.

    Article  PubMed  CAS  Google Scholar 

  78. Thomas JC, Sebek BA, Krishnamurthi V. Primitive neuroectodermal tumor of the kidney with inferior vena cava and atrial tumor thrombus. J Urol 2002;168:1486–1487.

    Article  PubMed  Google Scholar 

  79. Karnes RJ, Gettman MT, Anderson PM, et al. Primitive neuroectodermal tumor (extraskeletal Ewing’s sarcoma) of the kidney with vena caval tumor thrombus. J Urol 2000;164:772.

    Article  PubMed  CAS  Google Scholar 

  80. Marley EF, Liapis H, Humphrey PA, et al. Primitive neuroectodermal tumor of the kidney—another enigma: a pathologic, immunohistochemical and molecular diagnostic study. Am J Surg Pathol 1997;21:354–359.

    Article  PubMed  CAS  Google Scholar 

  81. Gonlusen G, Ergin M, Paydas S, et al. Primitive neuroectodermal tumor of the kidney: a rare entity. Int Urol Nephrol 2001;33:449–451.

    Article  PubMed  CAS  Google Scholar 

  82. Quezado M, Benjamin DR, Tsokos M. EWS/FLI-1 fusion transcripts in three peripheral primitive neuroectodermal tumors of the kidney. Hum Pathol 1997;28:767–770.

    Article  PubMed  CAS  Google Scholar 

  83. Casella R, Moch H, Rochlitz C, et al. Metastatic primitive neuroectodermal tumor of the kidney in adults. Eur Urol 2001;39:613–617.

    Article  PubMed  CAS  Google Scholar 

  84. Gonzalez-Lois C, Madero S, Redondo P, et al. Small cell carcinoma of the kidney: a case report and review of the literature. Arch Pathol Lab Med 2001;125:796–798.

    PubMed  CAS  Google Scholar 

  85. Majhail NS, Elson P, Bukowski RM. Therapy and outcome of small cell carcinoma of the kidney: report of two cases and a systematic review of the literature. Cancer 2003;97:1436–1441.

    Article  PubMed  Google Scholar 

  86. Mackey JR, AU HJ, Hugh J, et al. Genitourinary small cell carcinoma: determination of clinical and therapeutic factors associated with survival. J Urol 1998;159:1624–1629.

    Article  PubMed  CAS  Google Scholar 

  87. Akkaya BK, Mustafa U, Esin O, et al. Primary small cell carcinoma of the kidney. Urol Oncol 2003;21:11–13.

    Google Scholar 

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Novakovic, K.R., Campbell, S.C. (2008). Rare Malignancies of the Kidney: Evaluation and Management . In: Bukowski, R.M., Novick, A.C. (eds) Clinical Management of Renal Tumors. Humana Press. https://doi.org/10.1007/978-1-60327-149-3_38

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