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Copyright of Namık Kemal Tıp Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Renal cell carcinoma (RCC) is a significant cause of mortality worldwide. To date, many atypical metastatic sites have been observed and reported in patients with RCC. However, to the best of our knowledge, there have been no reported cases of thyroid cartilage metastasis in the context of RCC metastasis. Herein, we present the case of a 68-year-old man who developed left arm pain that led to an RCC diagnosis. First, evaluation by pan-computed tomography (CT) denoted right kidney RCC and identified left humeral metastasis. Subsequently, 18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) was performed after right nephrectomy and left humeral lesion excision and fixation. Interestingly, few intramedullary hypermetabolic lesions were observed in addition to a single intensely hypermetabolic thyroid cartilage lesion indicative of oligometastases. This case underscores the importance of 18F-FDG PET/CT in the evaluation of RCC disease for baseline staging and beyond. [ABSTRACT FROM AUTHOR]

Objective: In this study, the utility of histogram parameters derived from diffusion-weighted imaging to differentiate renal cell carcinoma (RCC) from renal minimal fat angiomyolipoma (MFAML) was investigated. Methods: In this retrospective study, 98 patients who were histopathologically diagnosed with RCC and MFAML and who underwent magnetic resonance imaging (MRI) examinations between 2015 and 2022 were included. Demographic data, preoperative MRI findings, MRI apparent diffusion coefficient (ADC) histogram analyses, operation types, and postoperative histopathological data of the patients were recorded. The mean, minimum (min), maximum (max), 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles as well as skewness, kurtosis, and variance of ADC values were calculated. Results: The study included 61 males and 37 females. Eighty eight of the patients had RCC and 10 had AML. In terms of age and gender, there was no significant difference between the two groups. The AML group's ADCmin, ADCmedian, ADCmean, ADCmax, 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles were all lower than those of the RCC group. ADCmax value (p<0.001), as well as ADCmedian and the 50th, 75th, 90th, and 95th percentiles of ADC values (p<0.05), demonstrated a statistically significant difference. However, there was no statistical significance between ADCmin, ADCmean, and the 5th, 10th, and 25th percentiles of ADC values (p>0.05). The area under the curve, sensitivity, and specificity of the ADCmax value were 0.795, 62.4%, and 88.9%, respectively. Conclusion: A whole tumor histogram and textural analysis of ADC values could be useful in distinguishing MFAML from RCC. [ABSTRACT FROM AUTHOR]

Objective: The goal of this research is to evaluate the efficiency of computed tomography texture analysis in differentiating renal cell carcinoma from a high-attenuation renal cyst on non-contrast computed tomography. Methods: Forty-nine non-contrast abdominal computed tomography examinations, 27 patients with high-attenuation renal cyst and 22 patients with renal cell carcinoma were evaluated retrospectively. Region of interest was drawn to cover the entire lesion in the sections. Gray-level intensity (Hounsfield Unit value), entropy, standard deviation, uniformity, kurtosis, skewness, size% lower, size % mean, size% upper, values were obtained by texture analysis. The findings of both groups were compared statistically. Results: Mean and median gray-level intensity values and entropy values were significantly higher in renal cell carcinoma than in high-attenuation renal cyst (p<0.001). There was no significant difference in other parameters. When receiver operator characteristics analysis was performed for the mean value, the area under the curve value was found to be 0,754. When the threshold value was selected as 34.5708, 72.7% sensitivity and 66.7% specificity was found. Conclusion: Texture analysis may be useful in differentiating renal cell carcinoma from high-attenuation renal cysts on non-contrast computed tomography. [ABSTRACT FROM AUTHOR]

Objective: Malignant melanoma (MM) and renal cell carcinoma (RCC) are rare radioresistant tumors that often metastasize to the brain. Because of their rarity, studies on brain metastatic RCC and MM are limited. We aimed to outline the characteristics of brain metastasis (BM) patients from RCC and MM and analyze the potential prognostic factors for survival. Materials and Methods: This is a retrospective-observational study using data from patients admitted to a radiotherapy (RT) center of a university hospital between 1998-2020. Clinicopathological characteristics, treatment details, and outcome results were analyzed. Univariate and multivariate survival analyses were performed. Results: Among a total of 14,603 patients treated in our center in the study period, only 52 (0.004%) were BM cases from MM or RCC. Forty patients had complete data (median age at diagnosis of MM or RCC-related BM: 57.7; females: 25%; MM in 52.5% and RCC in 47.5%). The time between primary diagnosis and first extracranial metastases was weakly correlated with the time between diagnosis of extracranial metastasis and BM (r=0.405, p=0.021). Among the potential prognostic factors on survival [age, sex, older vs younger age group, primary diagnosis (MM vs RC), presence of extracranial metastasis, number of BM, location of BM, presence of gross total resection, dose of RT, completion of prescribed RT, field of RT], none were independently associated with survival. Conclusion: Our findings suggest that when MM or RCC patients develop brain metastasis, survival is limited without any favorable prognostic factor belonging to the patient, the tumor, or the preference of the treatment. [ABSTRACT FROM AUTHOR]

Renal cell carcinomas is 2-3% of all adult cancers. Kidney cancer is currently the seventh most common cancer in men and the tenth most common in women. There were 19,3 million new cancer diagnoses and 10 million cancer deaths worldwide in 2020. Survival in renal cell carcinomas has a strong correlation with the stage of diagnosis. 5-year survival in stage 1 tumors is 93%, 72,5% in cases with local lymph node metastases and 12% in metastatic carcinomas cases. There is an inverse correlation between age / tumor size and survival. Metastatic lymph node, tumor necrosis and adipose tissue invasion are associated with poor prognosis. The study is including 179 renal cell carcinoma cases. The clinical and pathological datas of these cases were retrospectively analyzed from the Cumhuriyet University Hospital patient system. The distribution sex of cases are 111 males (62%) and 68 females (38%). The mean age of the 179 cases was 58,5±11,9 years (range of 21-90). The mean tumor diameter is 5,7±3,4 (range of 1-19 cm). The nuclear grades of cases are 53,1% with low grade and 46,8% with high grade. Radical nephrectomies were evaluated for vascular invasion, ureter invasion, capsule/adipose tissue invasion, lymph node metastasis and adrenal gland metastasis. There is a statistically significant relationship between nuclear grade and vein invasion, microvascular invasion, capsule/adipose tissue invasion (p<0,05). Also there is a statistically significant relationship between tumor diameters and vein invasion, microvascular invasion, capsule/adipose tissue invasion, lymph node metastases (p<0,05) However, there is not a statistically significant relationship between subtypes and vein invasion, micro vascular invasion, capsule/adipose tissue invasion, lymph node metastases, adrenal gland metastases (p>0,05). It was observed that the invasions increased as the nuclear grade and tumor diameters increased. These observations are statistically significant. [ABSTRACT FROM AUTHOR]

Copyright of Namık Kemal Tıp Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The aim of this study is to investigate whether the overexpression of human heparanase protein (HPSE) alternative variant protein called T5 is caused by increased expression of miR-6814-5p in human renal cell carcinoma (RCC) cases. In addition, the possible correlation between the clinical parameters of RCC cases and the expression levels of T5 and miR-6814-5p was evaluated. Materials and Methods: T5 and miR-6814-5p expression analysis was performed on ready-to-use RCC cDNA panel by qPCR method. This panel included 48 cDNA samples obtained from tumor tissues of 10 stage-1, 5 stage-2, 13 stage-3 and 11 stage-4 RCC patients and normal kidney tissues from 9 healthy individuals. Results: There was no significant correlation between TNM stages, Fuhrman nuclear grade and histological type and miR-6814-5p and T5 expressions. The expression level of miR-6814-5p in RCC tumor tissues was about 8-fold higher and the T5 expression level about 5-fold higher than healthy controls. MiR-6814-5p and T5 expression changes were statistically significantly correlated with neutrophil/lymphocyte ratio of RCC cases. Conclusion: MiR-6814-5p may play a role in the formation mechanism of T5 in RCC.

Purpose: The aim of this study is to investigate whether the overexpression of human heparanase protein (HPSE) alternative variant protein called T5 is caused by increased expression of miR-6814-5p in human renal cell carcinoma (RCC) cases. In addition, the possible correlation between the clinical parameters of RCC cases and the expression levels of T5 and miR-6814-5p was evaluated. Materials and Methods: T5 and miR-6814-5p expression analysis was performed on ready-to-use RCC cDNA panel by qPCR method. This panel included 48 cDNA samples obtained from tumor tissues of 10 stage-1, 5 stage-2, 13 stage-3 and 11 stage-4 RCC patients and normal kidney tissues from 9 healthy individuals. Results: There was no significant correlation between TNM stages, Fuhrman nuclear grade and histological type and miR-6814-5p and T5 expressions. The expression level of miR-6814-5p in RCC tumor tissues was about 8-fold higher and the T5 expression level about 5-fold higher than healthy controls. MiR-6814-5p and T5 expression changes were statistically significantly correlated with neutrophil/lymphocyte ratio of RCC cases. Conclusion: MiR-6814-5p may play a role in the formation mechanism of T5 in RCC. [ABSTRACT FROM AUTHOR]

Metastasis of renal cell carcinomas to the oral cavity is extremely rare. Here, we present a 77-year-old male patient with clear cell renal cell carcinoma metastasis in the mandible bone and discuss the differential diagnosis of primary and metastatic tumors in the head and neck region. [ABSTRACT FROM AUTHOR]

Amaç: Bu çalışmada renal hücreli karsinom (RHK) nedeniyle radikal ve parsiyel nefrektomi yapılan hastaların evrelere göre onkolojik sonuçlarının karşılaştırılması amaçlanmıştır. Bu amaçla klinikopatolojik özelliklerin rekürrenssiz sağkalım ve kansere özgü sağkalım üzerine etkileri incelendi. Materyal-Metod: 2004-2012 tarihleri arasında renal kitle nedeniyle kliniğimizde parsiyel/radikal nefrektomi uygulanan T3a ve altındaki 200 hastanın verilerini retrospektif olarak inceledik. Klinikopatolojik özelliklerin sağkalımlara üzerine istatistiksel etkileri olup olmadığı Log-Rank testi kullanılarak Kaplan Meier sağkalım analizi ile değerlendirildi. Her bir değişkene ilişkin 1- 3 ve 5 yıllık sağkalım hızları, ortalama yaşam süresi ve bu süreyle ilişkili %95 güven aralıkları hesaplandı. Bulgular: Tüm olgular içerisinde 1- 3 ve 5 yıllık rekürrenssiz sağkalım % 95.5, 90.5 ve 85.5, kansere özgü sağkalım % 98.8, 96.4 ve 92.3 olarak tespit edildi. PN grubunda RN grubuna göre rekürrenssiz sağkalım istatistiksel olarak daha yüksekti (p=0,014) ama kansere özgü sağkalımda fark gözlenmedi. Evrelere göre T1a, T1b ve T3a’ da rekürrrenssiz sağkalım ve kansere özgü sağkalım T2a ve T2b’ den daha yüksekti (p=0,023 ve p lt;0,001). T1a ve T1b evrelerinde 1- 3 ve 5 yıllık rekürrenssiz sağkalım ve kansere özgü sağkalım benzer olarak bulundu ve klinikopatolojik özelliklerle istatistiksel olarak ilişki tespit edilmedi. Tüm olgular içerisinde patolojik tümör boyutu (p=0,026) ve diğer (Toplayıcı kanal karsinomu) histolojinin (p lt;0,001) rekürrenssiz sağkalımı etkilediği görüldü. Tüm olgular içerisinde multivariate analizlerde yaş (p=0,010) ve patolojik tümör boyutunun (p=0,018) kansere özgü sağkalımı etkilediği görüldü. Sonuç: T1a ve T1b böbrek tümörlerinde parsiyel nefrektomi ve radikal nefrektomi yapılan hastalar arasında rekürrenssiz ve kansere özgü sağkalımların benzer olduğu gözlendi ve prognozunun herhangi bir klinikopatolojik özellikten etkilenmediği gözlendi. Klinikopatolojik ve demografik özelliklerin ileri evrelerde sağkalımla ilişkili olabileceği düşünüldü.

Copyright of Yeni Üroloji Dergisi is the property of Ali Ihsan Tasci and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç: Renal hücreli karsinomun kemik metastazları sıkça görülmekle birlikte el kemiklerine, özellikle metakarpal kemiklere metastaz oldukça nadir görülmektedir. Bu vakada tanıdan 9 yıl sonra metakarpal metastaz nedeni ile tedavi edilen hastayı bildirmekteyiz. Olgu: 50 yaşında erkek hasta 2013'te evre 4 renal hücreli karsinom tanısı ile kliniğimize başvurmuştur. Başlangıç görüntülemelerinde sol böbrekte kitle ve bilateral akciğer nodülleri saptanmıştır. Hasta bu bulgular ile 30.07.2013'te opere edilmiş, patolojisi renal hücreli karsinom ile uyumlu bulunmuştur. Hastaya tıbbi onkoloji bölümünde interferon tedavisi planlanmış ancak yan etkiler nedeniyle sunitinibe geçilmiştir, tedavi altında akciğer nodülleri yanıtlı olarak takip edilmiştir. Tanıdan 9 yıl sonra hastanın sol elinde şişlik şikayeti gelişmesi üzerine yapılan incelemelerinde Şubat 2021 tarihli manyetik rezonans görüntülemede sol el 2. metakarpal dorsalinde 22x7 milimetre ve palmar bölgede 11x8 milimetrelik nodüler lezyonlar görülmüştür (Şekil 1). İleri tetkik amaçlı çekilen pozitron emisyon tomografisi/bilgisayarlı tomografide bilateral akciğer nodüllerinde progresyon ve sol el 2. metakarp distalinde kemikte bütünlük kaybına neden olan lezyon saptanmıştır. 10.03.2021 tarihinde alınan ince iğne aspirasyon biyopsisi renal hücreli karsinom metastazı ile uyumlu bulunmuştur. Bu bulgular eşliğinde hasta tarafımıza yönlendirilmiş ve radyoterapi planlaması yapılmıştır. 21.04.2021-03.05.2021 tarihleri arasında sol el 2. metakarp bölgesine 30 Gy/10 fr eksternal radyoterapi uygulanmıştır. Sonuç: Akrometastazlar (diz ve dirsek ekleminin distalini içeren kemik bölgeleri) tüm kemik metastazlarının %0.1'ini oluşturmaktadır. Literatür taraması yapıldığında tüm akrometastazların oranı falankslar %68.4, karpal kemikler %14.2, metakarpal kemikler %14.2 ve diğer bölgeler %3.2 olarak bulunmuştur. En sık akciğer kanserinin metastaz yaptığı saptanmıştır.1 Renal hücreli karsinomların yaklaşık %30'luk kısmının kemik metastazları yaptığı bilinse de el kemikleri metastazı literatürde birkaç olgu şeklinde bildirilmiştir. 2 Renal hücreli karsinom tanısı almış hastalarda elde şişlik, ağrı gibi durumlarda saptanan kemik lezyonlarında, tanıdan uzun yıllar geçmiş olsa bile metastaz olasılığı göz önünde bulundurulmalıdır. Hastaların tedavilerinde cerrahi, radyoterapi ve sistemik tedavi ajanları kullanılabilir. Nadir görülen bu olgular için multidisipliner şekilde tedavi kararı alınması önemlidir. [ABSTRACT FROM AUTHOR]

Objective: We aimed to determine the risk factors related to patient, tumor characteristics and surgery that may be associated with decline in renal function during follow-up after partial nephrectomy (PN). Materials and Methods: Sixty-one patients who underwent PN due to localized stage Ia renal cell carcinoma between January 2010 and October 2018 were retrospectively analyzed. Demographic characteristics of the patients, clinical and pathological data, information about surgical techniques, preoperative score to predict postoperative mortality (POSPOM), Age-adjusted Charlson Comorbidity index (ACCI), Eastern Cooperative Oncology Group score, American Society of Anesthesiologists' score, preoperative estimated glomerular filtration rate (eGFR) and eGFR levels during postoperative follow-up were recorded. Results: Twelve (19.7%) patients experienced a decline in eGFR (<60 mL/min/1.73 m2) at the postoperative follow-up of median 30 months. Older age, higher Body Mass index, presence of hypertension, Diabetes Mellitus, tumor in the hilar region, higher scores of POSPOM, ACCI, RENAL and PADUA, lower preoperative eGFR, cold ischemia technique, total arterial clamping technique, longer warm ischemia time, longer cold ischemia time and lower preserved renal parenchymal volume (RPV) were found to be associated with both short- and long-term decline in eGFR (<60 mL/ min/1.73 m2). Conclusion: Although lower percentage of preserved RPV is a significant predictor of the postoperative deterioration of renal function, our results have shown that preoperative POSPOM score, ACCI and eGFR levels are just as important as surgical factors. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Multiple tumors that occur at the same time are defined as synchronized tumors. Occurrence of renal cell carcinomas with synchronous tumors is a rare condition. A 79-year-old female presented with complaints of intermittent fever, anemia, loss of appetite and weight. Imaging studies revealed the presence of pancreatic lesion with proximal choledocal dilatation and a mass lesion in lower pole of the left kidney. The patient was treated successfully by open left partial nephrectomy for the renal cancer and pancreaticoduodenectomy with cholecystectomy for the pancreatic lesion. In this case report, a patient who has synchronous adenocarcinoma of ampulla of Vater and renal cell carcinoma will be presented. [ABSTRACT FROM AUTHOR]

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The association of preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with postoperative tumor stage and Fuhrman nuclear grade was investigated in patients with renal cell carcinoma (RCC). Materials and Methods: Data of 123 patients, who were operated due to RCC, in our clinic was analysed. NLR and PLR were evaluated in patients who were classified according to tumor stage (T1 and T2 low stage, T3 and T4 high stage) and Fuhrman nuclear grade (grade 1 and 2 low-grade, grade 3 and 4 high-grade). NLR and PLR were compared using Levene's test between the groups. Results: Sixty four patients were female (52.1%) and 59 were male (47.9%). All haematological parameters were expressed as 103/µL. Mean age, blood neutrophil, lymphocyte and platelet counts, and NLR and PLR values of the patients were 62.49±12.43 years, 6.27±2.8, 2.05±0.83, 263.72±89.03, 4.01±3.93, and 149.73±82.1, respectively. The most common histologic subtype was recorded as clear cell RCC (76.4%). NLR and PLR were 3.83±3.22 and 142.79±66.66, respectively in the low-stage group and 4.43±5.29 and 165.85±109.41, respectively in the high stage group. As for the Fuhrman nuclear grading, NLR and PLR were 3.81±3.45 and 146.63±87.36, respectively in the low-grade group and 4.61±5.387 and 159.32±63.42 in the high-grade group. There was no statistically significant difference between the groups (p>0.05). Conclusion: Although not statistically significant, high tumor stage and nuclear grade were positively correlated with NLR and PLR. It is concluded that, further multi-center and prospective studies with larger samples are needed to derive meaningful results. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Internal Medicine / Türkiye Klinikleri İç Hastalıkları Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Renal hücreli karsinom metastatik tümörler pankreas kanserlerinin yaklaşık %2’sini oluşturur. İzole pankreas metastazlarının kaynaklandıkları primer tümörler renal orjinli, takiben kolorektal kanser, melanom, meme, akciğer kanserleri, sarkomlardır. Bu makalede, PET-BT’de F18-FDG tutulumu göstermeyen renal hücreli karsinomun pankreas metastazının radyolojik bulguları sunulmuştur

Metastatik tümör; orjinini Santral Sinir Sistemi (SSS) dışındaki dokulardan alan primer sistemik kanserlerin sekonder olarak SSS ne yayılmasıdır. Erişkinde SSS ne en sık metastaz sırasıyla akciğer, meme, malign melanom, renal hücreli Ca, kolon ve tiroid kanserinden gelir. Akciğer kanseri %30-60 oranında beyine metastaz yapar. Çocukta beyin metastazı oldukça azdır. En sık lösemi, lenfoma, osteogenik sarkom, rhabdamyosarkom ve germ hücreli tümörler beyne metastaz yaparlar. Malign melanom, akciğer, meme ve kolon kanserleri %50 oranında multipl metastaz yaparken renal tümörler tek metastaz yapmaya meyillidir. Akciğer kanseri tanı koyduktan 6-9 ay sonra beyne metastaz yaparken, renal kanser 1 yıl, kolon kanseri 2 yıl, meme kanseri ve malign melanom 3 yıl sonra beyine metastaz yapabilir. %6 olguda primer tümöre ait hiçbir bulgu yokken beyine metastaz olmaktadır. Tedavide verilen ilk ilaç kortikosteroiddir, daha sonra ameliyat, Radyoterapi (RT), Kemoterapi (KT) ve Stereotaktik Radyosurgery (SRS) yapılabilir. Küçük hücreli akciğer kanseri, lenfoma, germ hücreli tümörler RT ve KT"ye hassastırlar. Non small akciğer kanserleri, renal, kolon, malign melanom radiorezistandır. Eğer hastada 3-4 aydan uzun yaşam süresi bekleniyorsa agresif tedavi uygulanır. RT"de verilen dozun total miktarı ve veriliş süresi ile ilgili akut ve kronik komplikasyonlar meydana gelir. Metastatik tümörlerin ameliyatlarında amaç nörolojik defisit olmadan tümörün total çıkartılması, intrakranial basıncın azaltılması ve eğer postoperatuar RT yapılacaksa dozun mümkün olduğu kadar düşük tutulmasıdır. Önceleri multipl metastazlar opere edilmemekte idi ancak ne kadar çok metastaz alınırsa RT ve KT den o kadar çok cevap alındığından günümüzde ameliyat önemlidir. Anahtar Kelimeler: Metastatik beyin tümörleri, Stereotaktik radyosurgery, Malign melanom, Akciğer kanserleri, Renal hücreli karsinom, Radyoterapi, Kemoterapi

von Hippel-Lindau hastalığı; retinal, spinal ve serebellar hemanjioblastom, renal hücreli karsinom, feokromositoma, pankreatik kist ve tümörler, endolenfatik kese tümörleri gibi benign ve malign tümörlerin gelişimi ile karakterize kalıtsal bir hastalıktır. Epididimde ve broad ligamentte kistler ve papiller kistadenokarsinom oluşabilir. Radyolojik görüntüleme yöntemleri von Hippel-Lindau hasta- lığının tanısında, tedavisinde ve takibinde önemli bir yere sahiptir. Bu yazıda, multi-organ tutulumları olan 32 yaşındaki bir erkek hastada, von Hippel-Lindau hastalığının radyolojik bulgularını paylaşmak amaçlanmıştır

Renal hücreli karsinom yetişkinlerde görülen böbrek tümörlerinin en yaygın formudur. Böbrek hücrelerinin adeno karsinomu veya hipernefroma olarak adlandırılır. Çoğunlukla %60 oranında görülen tipi clear cell karsinomadır. En sık 50-60 yaş arasında görülür. Deri metastazları oldukça nadirdir fakat görüldüğünde prognozun kötü olduğunu ve lezyonun sistemik yayılımının olduğunu göstermektedir. Göğüs cerrahi kliniğinde görülen hastada, skalpte frontal bölgede kanamalı büyük bir kitle bulunmakta idi. Hastanın Renal hücreli karsinom nedeniyle 3 yıl önce sağ böbreği alınmıştı. Enfeksiyon hastalıkları kliniğinde pnömoni tedavisi almış fakat düzelme olmayınca göğüs cerrahi kliniğine biyopsi için yatırılmıştı. Yapılan biyopsiden renal hücreli karsinom tanısı almıştı. Hasta Dermatoloji ve Plastik cerrahi kliniğine frontal bölgedeki lezyon nedeniyle konsülte edildi. Pyojenik granülom ön tanısıyla eksizyon yapıldı. Patolojik tanı renal hücreli karsinom metastazı olarak geldi. Renal hücreli karsinomun sıklıkla akciğerler, kemik, deri, karaciğer ve beyne metastaz yaptığı literatürde gösterilmektedir. Bu hastalarda prognoz oldukça kötüdür. Hasta şifa ile taburcu edildi fakat yakınlarından alınan bilgiye göre hastaneden çıktıktan 3 ay sonra eksitus olduğu öğrenildi.

Renal hücreli karsinomun çocukluk çağındaki tedavisi esas olarak geniş cerrahi rezeksiyon ile yapılmaktadır. Çoğu evre I-II vaka için radikal nefrektomi ve lenf nodu diseksiyonu yeterli olurken ileri evrelerde immünoterapinin de dahil olduğu farklı tedavi yöntemleri tanımlanmıştır. Burada tanı anında opere edilemeyen, sonrasında interferon alfa ile başarılı bir şekilde tedavi edilen ileri evre renal hücreli karsinomu olan 9 yaşında bir kız sunulmuştur.

Objective: Current guidelines for the management of renal mass recommend thoracic imaging for potential metastatic nodules. Small size of the renal mass can be associated with low metastatic potential, which might question the necessity of thoracic imaging in this patient population. This study sought to evaluate the association of thoracic imaging findings with the renal mass characteristics in patients with pathologically proven renal cell carcinoma (RCC). Materials and Methods: We performed a retrospective analysis of patients with RCC, who underwent radical/partial nephrectomy and had baseline thoracic imaging available for review. Patients with a suspicious pulmonary mass were evaluated by the Department of Thoracic Surgery. Presence of lung nodule(s) and metastasis was determined and compared with patient and renal mass characteristics. Results: A total of 215 patients were included in the study. Pulmonary nodules suspicious for malignancy were present in 26.8% of the cases and 42% of these patients underwent further examination for the presence of a pulmonary mass. Pathological examination of the pulmonary nodule revealed RCC metastasis in 80% of patients who underwent biopsy or excision of the pulmonary nodule. Of note, in the subgroup analysis according to the pathological stage of the renal mass, 19.3% of patients with pT1a disease had a suspicious pulmonary mass on thoracic imaging. Of these patients, 25% underwent further examination of the pulmonary nodule with a RCC metastasis in 66.6%. Conclusion: The presence of suspicious lung nodules in patients with RCC has metastatic potential regardless of the size of the renal mass. These findings underscore the importance of baseline thoracic imaging and vigilant further evaluation of patients in whom pulmonary nodules are identified. [ABSTRACT FROM AUTHOR]

Purpose: Renal cell carcinoma (RCC) is genetically characterized by the recurrent loss of the short arm of chromosome 3. Classically, Von Hippel Lindau (VHL) was the only frequently mutated gene in RCC. Recently, several novel frequent mutations of histone modifying and chromatin remodeling genes, including PBRM1 and SETD2, were identified. In the present study, we aimed to determine the possible relationship between PBRM1 and SETD2 genes, and renal cell carcinoma by molecular techniques. Material and Methods: Screening possible mutation and determining mRNA expression level of PBRM1 and SETD2 genes in 20 pairs of tumor and normal samples of RCC patients were performed by nucleotide sequencer and reverse transcription- polymerase chain reaction (RTPCR). Results: The mRNA expression levels of both genes were significantly reduced in tumor samples when compared with the control samples. As a result of mutational analysis, a single insertion nucleotide polymorphism in exon 12 of SETD2 gene was detected in one patient. Conclusion: Reduced mRNA expression level of PBRM1 and SETD2 might be risk factor for RCC development. Further analysis is warranted to investigate responsible genes rather than PBRM1 and SETD2 in RCC. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma (RCC) accounts for approximately 3% of malignancies and 80-90% of malignant neoplasms of the kidney in adults. The incidence of RCC continues to increase. Due to widespread use of cross-sectional imaging modalities, small and localized tumors are now being detected at an early stage. Percutaneous image-guided thermal ablation for early stage RCC is a minimally invasive technique that has rapidly gained acceptance as an alternative to surgery. This technique provides a low incidence of complications, shorter operative-time, protection of renal function, lack of inherent surgery risks, and shorter hospital stay while remaining an effective method of adequate destruction of tumor tissue. The current ablation techniques include cryoablation, radiofrequency ablation (RFA), high-intensity focused ultrasound and microwave ablation (MWA). Image-guided percutaneous MWA has been effectively and safely applied to treat renal tumors in select patients. In contrast to RFA, percutaneous MWA has the advantage of providing higher temperatures in a shorter time. Thus, MWA allows a more uniform tumor necrosis than RFA. The indications for renal MWA include T1a or T1b tumors (=4 cm or 4-7 cm), patients with multiple comorbidities who are poor candidates for resection, a tumor in a solitary kidney, bilateral renal tumors, hereditary renal tumors, renal insufficiency, von Hippel-Lindau syndrome, and palliative treatment of hematuria. In conclusion, percutaneous MWA appears to be a safe and effective treatment option for T1a and T1b tumors and for patients who are poor surgical candidates. [ABSTRACT FROM AUTHOR]

Metastatic lesions of the nasal cavity and paranasal sinuses are rare tumors. Carcinomas originating from intrapelvic organs play an important role in the differential diagnosis of these masses because of their paradoxic spread to the head and neck region. In this study we report a case with metastatic renal cell carcinoma of the caudal nasal septum. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases are among the most common causes of death in the world and in our country.Venous Thromboembolism (VTE) is the most important cause of mortality after DVT.Survival is worse in patients with cancer diagnosed concomitantly with deep vein thrombosis.However, information on specific malignancies is limited.If the treatment is started after DVT and the etiology is not investigated, new diagnosis malignancy treatment may be delayed and cause mortality, especially in elderly patients.Our patient, 58 years old, was diagnosed with DVT,after the dvt clinic did not regress and was investigated for malignancy. Left Renal Cell Carcinoma was diagnosed and surgically treated. [ABSTRACT FROM AUTHOR]

Background: Expression of endoglin relates to clinical, metastatic, and histopathological features of tumor, as well as to prognosis. The aim of the present study was to investigate the expression and clinical significance of endoglin in renal cell carcinoma (RCC). Methods: A total of 103 (27 women, 76 men) RCC samples were obtained from patients who had undergone radical or partial nephrectomy in the clinic between the years of 2005 and 2011. Samples were assessed with tissue microarray technique using immunohistochemical endoglin staining. Results: No significant correlation was observed between intensity of endoglin expression in RCC and metastasis (p=0.469), Fuhrman grade, or tumor staging (p=0.419 and p=0.063, respectively). Neither was a correlation observed between the survival and expression of endoglin (p=0.194). However, it was determined that papillary RCC expressed significantly lower endoglin intensity than clear-cell RCC (mean: 1.09). Conclusion: Endoglin expression did not correlate with clinical stage or metastatic potential of RCC. However, low expression of endoglin in papillary RCC may have implications regarding the efficacy of targeted therapy in metastatic cases of this histological subtype. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma (RCC) is the most common tumor of the kidney. The incidence of RCC has been increasing with the dissemination of imaging techniques, including computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound. Radiologic imaging plays a central role in its detection, staging, treatment evaluation and followup. The main aim of this article was to review of efficiency of the current radiologic examination in RCC. [ABSTRACT FROM AUTHOR]

Duodenorenal fistula is a rare condition. The right kidney and the second part of the duodenum are in close anatomic proximity. Although unusual, fistulae can occur between these two anatomic structures. We report a patient who presented with duodenorenal fistula after radiofrequency ablation for renal cell carcinoma and its hepatic metastasis. [ABSTRACT FROM AUTHOR]

Congenital anomalies of the kidney and urinary tract are common and include a wide anatomic spectrum. Duplex systems are one of the more common renal anomalies, with the majority being asymptomatic. Little is known about the molecular pathogenesis of these anomalies; however, certain causative genes have been implicated. The finding of renal cell carcinoma arising in a kidney with the duplication of pelvicalyceal system and ureters, as in the present case, is uncommon. The association between a duplex system and renal cell carcinoma may be more than a coincidence, requiring a deeper insight and further elucidation. [ABSTRACT FROM AUTHOR]

Objective: Renal cell carcinoma (RCC) is a malignancy originating from the renal cortex and is accounted for 85% of all malignant kidney tumors. Currently, tumor stage and nuclear grade are recognized as the most important determinants of prognosis in patients with RCC. Nonetheless, staging and grading do not suffice for predicting the prognosis in many patients. However, determining such patients bears importance in terms of oncology. Therefore, additional parameters are required to define the tumor behavior. In this study, we aimed to investigate the relation of Cox-2, Bax, Bcl-2, and p53 expression, as well as Ki-67 proliferation index to histopathologic parameters, and their impact on prognosis. Material and Methods: Our study included 70 RCC patients who were referred to the Pathology Department of Izmir Ataturk Teaching and Research Hospital from the First Urology Clinic between May 1998 and May 2008. The data including tumor diameter, histologic tumor type, nuclear grade, tumor stage, metastatic status, life expectancy of patients as well as staining percentages of Bax, Cox-2, Bcl-2, p53, and Ki-67 were compared. Results: In this study, no relationship was found between those markers and clinicopathologic parameters including the prognosis. Conclusion: Tumor pathologic stage showed a statistically significant predictive value for metastasis development, however, it failed to predict survival. There is a need for studies including standardized methods, larger samples, and longer follow-up periods in order to reveal effects of Cox-2, Bax, Bcl-2, P53 markers, and Ki-67 proliferation index on prognosis. [ABSTRACT FROM AUTHOR]

Metastatic tumor is secondary spread to the central nervous system of primer systemic cancers originating from tissues other than the central nervous system. In adults; there are metastases respectively from lungs, breasts, malign melanoma, renal cell carcinoma, colon and thyroid cancers.30-60% of lung cancers metastasis to the brain. In children there are quite a few cerebral metastases. Most commonly leukemia, lymphoma, osteogenic sarcoma, rhabdomyosarcoma and germ cell tumors metastasis to the brain. 50% of malign melanoma, lung, breast and colon cancers intend to make multipl metastases but renal cell cancers intend to make solitary metastasis. While lung cancers metastasis to brain in 6-9 months after the definitive diagnosis, renal cancers in 1 year, colon cancers in 2 years, breast cancers and malign melanoma in 3 years metastasis to brain. In 6% of cases there are cerebral metastasis while there isn't a symptom of a primary tumor.For treatment corticosteroids, surgery, radiotherapy (RT), chemotherapy (CT) and stereotactic radiosurgery (SRS) can be implemented. Small cell lung cancers, lymphoma, germ cell tumors are sensitive to RT and CT. Non small cell lung cancers, renal, colon cancers and malign melanoma are radioresistant. The purposes in the surgery of the metastatic brain tumors are; total resection of tumors without neurologic deficits, decreasing the intracranial pressure and decreasing the dose of postoperative radiotherapy. [ABSTRACT FROM AUTHOR]

von Hippel-Lindau disease is a hereditary disorder characterized by development of benign and malignant tumours such as retinal, spinal, and cerebellar haemangioblastomas, renal cell carsinomas, phaeochromocytomas, pancreatic cysts and tumors, endolymphatic sac tumors. Cysts and papiller cystadenocarcinoma of the broad ligament and epididiyms may also occur. Radiologic imaging methods has an important role in the diagnosis, treatment and following of von Hippel-Lindau. In this case, we aimed to present the radiologic findings of von Hippel-Lindau disease's radiological features in a single patient 32-year-old man who had multi-organ involvements. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma (RCC) skin metastasis is quite rare, seen in the rate of 1-3.3%. We present here a RCC case that thrives skin metastasis after 5 years of diagnosis. A 57-year-old male patient was diagnosed as RCC 5 years ago and left nephrectomy was made. In the patient without metastasis at the diagnosis, metastasis developed 1 year after the diagnosis. The patient underwent palliative chemotherapy and radiotherapy. During follow-up of the patient, a large number of new emerging, purple red style nodular skin lesions were seen on the face and scalp. After the biopsy made from nodules, it was evaluated as skin metastasis of RCC. One month later that skin metastasis developed, the patient died. As a result, the skin metastasis of RCC is extremely rare, and indicator of poor prognosis. [ABSTRACT FROM AUTHOR]

Malignant tumors of the kidney accounts for approximately 2-3% of the all new primary cancers cases diagnosed in the US, with an estimated 60.000 cases occurring annually. Current epidemiological studies provide convincing evidence linking environmental arsenic exposure to an elevated risk of renal cell carcinoma (RCC). High levels of arsenic leaching from natural underground sources have contaminated newly drilled wells, leading to cancers of the skin, lung, liver, kidney, and bladder. This link has been the basis for regulatory actions. In 2002, the US Environmental Protection Agency (EPA) lowered the maximum contaminant level for the amount of arsenic allowed in drinking water from 50 ppb to 10 ppb (10 μ/L). In addition, recent molecular biology research on familial kidney cancer syndromes indicate that inactivation mutation in VHL tumor suppressor gene contributes to clear cell RCC development. Future studies using animal models are needed to explain genetic susceptibility in VHL mutations and carcinogenic effect of arsenic exposure. [ABSTRACT FROM AUTHOR]

Objective: Mucinous tubular and spindle cell carcinomas (MTSCC’s) are recently described rare type of renal cell carcinoma (RCC). MTSCC’s are characterized by small, elongated tubules lined by cuboidal cells and/or cords of spindled cells separated by pale mucinous stroma. They have morphological similarities to papillary RCC (papRCC). We evaluated the importance of the immunohistochemical features in the differential diagnosis of MTSCC and papRCC. Material and Method: We re-evaluated 9 cases of MTSCC diagnosed between 2004 and 2010 and compared 10 cases of papRCC. All tumorswere stained with alpha methylacyl-CoA racemase (AMACR), cytokeratin 7 (CK7), CK19, renal cell carcinoma marker (RCC Ma), CD10 and kidney specific cadherin (KspCad). Results: A total of 6/9 cases were considered classical. Two of 9 MTSCC’s were classified as “mucin-poor”. Foamy macrophages were identified in 4 cases. The immunoreactivity in MTSCC was AMACR 100%, CK7 100%, CK19 100%, RCC Ma 50%, CD10 11%,and KspCad 38% while the values for papRCC were AMACR 100%, CK7 90%, CK19 100%, RCC Ma 100%, CD10 80%, and KspCad 0%.Conclusion: MTSCCs may include little mucin and show a markedpredominance of either of its principal morphological components. They may mimic other forms of RCC. Pathologists should be aware of the histological spectrum of MTSCCs to ensure an accurate diagnosis. Careful attention to the presence of a spindle cell population may be helpful in the differential diagnosis in tumors with predominant compact tubular growth. Immuno histochemical stains for papRCC are also expressed in MTSCC, but strong CD10 expression may not favor MTSCC. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma (RCC) is the most common primary malignant tumor of renal parenchyma. RCC metastases most commonly occur in the lung, liver, bone, brain, lymp nodes, and contralateral kidney. Adrenal gland metastasis from renal cell carcinoma is generally ipsilateral, and frequently clinically and functionally silent. Synchronous bilateral adrenal gland metastases from RCC are very rare, and 18 other cases were reported in the literature. In this article, we aimed to present a case of bilateral synchronous adrenal metastases from left kidney RCC in a 58-year-old man with radiologic findings and review the literature. [ABSTRACT FROM AUTHOR]

Renal epithelial cells comprise distinct pathological and physiological differences. Renal epithelial neoplasms derived from these cells may show overlapping morphological features, and differential diagnosis requiring the use of ancillary methods. The purpose of this study was to determine the diagnostic utility of the immunohistochemical expression patterns of a wide range of markers in renal epithelial cells. Normal renal cortical parenchyma and renal pelvis were immunostained for cytokeratin (CK) subtypes (CK7, CK19, CK34âE12), vimentin, RCCMa, CD10, CD117, AMACR, WT-1, EMA and p63. The immunohistochemical expression patterns were examined in 10 cases. Although there is some overlap, subtypes of epithelial cells showed distinctive CK and CD expression profiles. Proximal tubular cells showed CD10, RCCMa, AMACR expression. Distal tubular cells and collecting ducts showed CK7, CK19 and EMA expression. Urothelial cells showed CK7, CK19, CK34âE12, and p63 expression. CD117 and vimentin selectively stained intermittently in some cells lining the tubules. Endothelial cells and visceral epithelial cells stained with WT-1. Glomerular epithelial cells stained with CD10, but focal and intermittent staining with AMACR, CK7, CK 19, and RCCMa was found in parietal cells. In conclusion, a panel of cytokeratins, CDs and other markers are helpful in distinguishing epithelial cells and urothelial cells. The expression patterns of these markers may be helpful in the differential diagnosis of epithelial neoplasms. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy of the biphasic and triphasic dynamic multidedector computerized tomography (MDCT) in the preoperative prediction of histological subtypes of renal cell carcinoma (RCC). Materials and methods: The preoperative dynamic MDCT findings of 51 patients with renal mass who had undergone nephrectomy were reviewed retrospectively. Twenty-five of the patients had biphasic (portal and excretory) and 26 had triphasic (arterial, portal, and excretory) MDCT images. Tumor size, presence of calcification, tumor-aorta attenuation values in all phases and homogeneicity of the tumor were noted for every patient. In heterogeneous tumors, the minimum and maximum attenuation values were noted to determine the extent of heterogeneicity. These data were compared for histopathological subtypes of the tumors. Results: In 8 patients, calcifications were detected in the mass although there were no significant differences among tumor subtypes with regard to the presence of calcification. In 33 patients the tumor was hypervascular with 24 clear type and clear type RCC showed more prominent contrast enhancement than papillary RCC. The enhancement degree showed no significant difference among other tumor subtypes. Moreover, when biphasic and triphasic computed tomography (CT) findings were compared, the positive predictive value of triphasic CT in detecting hypervascular clear tumors was greater (17/18; 94.4% versus 7/11; 63.6%). Conclusion: The dynamic MDCT technique appears to be useful in preoperative evaluation of renal masses suspected of being malignant and may also provide information about the histopathological subtype of RCC. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma and urothelial carcinoma of the upper urinary tract are not rare urological malignancies, however, in a patient with renal cell carcinoma and urothelial carcinoma seen simultaneously in the same kidney is a rare event. We present a patient with a renal mass who underwent laparoscopic radical nephrectomy in our clinic. Pathology results revealed renal cell carcinoma and urothelial carcinoma, therefore, ureterectomy and cuff excision were performed. Pathological investigation of the ureterectomy specimen revealed urothelial carcinoma of the proximal ureter. We report this rare case with a literature review. [ABSTRACT FROM AUTHOR]

Objective: Overexpression of cyclooxygenase-2 (COX-2) and its association with angiogenesis have been shown in various carcinomas. In this study, we investigated COX-2 expression in clear cell type renal cell carcinoma and its association with microvessel density and various clinicopathologic parameters. Material and Method: Fifty cases of clear cell type renal cell carcinoma that underwent radical nephrectomy were included in this study. The status of COX-2 expression was examined immunohistochemically. Microvessel density in the neoplasm was estimated using the computerized image-analizer system. We evaluated the correlation between COX-2 expression, microvessel density and clinicopathologic findings. Results: COX-2 expression was observed in 76% of the cases. There was no association between COX-2 expression and microvessel density, age, sex, tumor size, nuclear grade and stage (p>0.05). Conclusion: Most clear cell type renal cell carcinomas expressed COX-2, but there was no relationship between COX-2 and various clinicopathologic parameters. Similar studies to explore therapeutic agents that target these specialities can be useful in the treatment of renal cell carcinomas which show COX-2 expression and high vascularity. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate intraobserver and interobserver reproducibility of Fuhrman nuclear grading of renal cell carcinoma. Methods: Pathology slides from 46 cases of renal cell carcinoma were rescored by 2 pathologists according to the Fuhrman system. Both intraobserver and interobserver reproducibility were assessed using kappa statistics. Results: The initial Fuhrman grade was grade 1 in 4 of the cases (8.7%), grade 2 in 30 (65.2%), grade 3 in 11 (23.9%), and grade 4 in 1 (2.2%). After reviewing the slides by the same pathologist, grades were reassigned as follows: grade 1 in 8 cases (17.4%), grade 2 in 23 (50%), grade 3 in 14 (30.4%), and grade 4 in 1 (2.2%). Intraobserver reproducibility of the Fuhrman system was substantial (? = 0.66). Fuhrman grading by the second pathologist was grade 1 in 11 cases (23.9%), grade 2 in 27 (58.7%), grade 3 in 7 (15.2%), and grade 4 in 1 (2.2%). Interobserver reproducibility of the Fuhrman system was moderate (κ = 0.42). Conclusions: Despite substantial intraobserver reproducibility of Fuhrman grading, moderate interobserver reproducibility and low agreement for grade 3 should be a consideration. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma is the most common malignancy of the kidney and radical nephrectomy is the gold standard treatment for this disorder. Nephron sparing surgery is increasingly being used to treat patients with early stage renal cell carcinoma. This is a case report of bilateral renal cell carcinoma in a 58-year-old white woman. A right partial and left radical nephrectomy was performed. Renal functions were evaluated using serum creatinine levels and technetium-99m-dimercaptosuccinic acid (Tc-99m-DMSA) scintigraphy after partial nephrectomy. The patient had no complication on postoperative control and did not need hemodialysis. [ABSTRACT FROM AUTHOR]