Unilateral renal oncocytoma: A case report

A case of unilateral renal oncocytoma is reported. Diagnosis, clinical features and management of the tumour are discussed in the light of international literature.The value of angionephrography in the diagnosis of the tumour and in the preoperative planning of surgical therapy is emphasized.     

A case of renal oncocytoma with cystic formation

A 60-year-old man was admitted to our hospital because of a right renal mass incidentally detected by ultrasonography during a general health check. Computerized tomography (CT) and magnetic resonance imaging (MRI) revealed a solid mass measuring 6 cm diameter containing a cystic portion in the right kidney. Cystic renal cell carcinoma was suspected, and right nephrectomy was performed. The gross appearance showed a well circumscribed mahogany brown tumor in the lower portion. On cross section of the tumor, a solid mass was seen in the cystic portion. Microscopically, oncocytic cells with eosinophilic granular cytoplasm were scattered on the cystic wall, and tumor cells formed microcystic structures in the solid part. Therefore, the tumor was diagnosed as renal oncocytoma with cystic formation. Only twelve cases have previously been reported in the literature.     

A case of renal oncocytoma with multilocular cyst

A 63-year-old woman was admitted to our hospital for a left renal tumor with multiple cystic lesions. Computed tomography and renal angiography revealed a hypovascular tumor 9 cm in diameter and multilocular cyst with a thick wall. Renal cell carcinoma and multilocular cystic nephroma were suspected, and left nephrectomy was performed. Histopathological diagnosis of this tumor was renal oncocytoma.     

A case of renal oncocytoma with synchronous contralateral renal cell carcinoma

A case of bilateral, synchronous renal cell carcinoma and oncocytoma is reported. The patient was a 70-year-old woman. Computed tomographic scan revealed bilateral low density masses, which had a diameter of approximately 4 cm (right kidney), and 2.5 cm (left kidney). We suspected bilateral renal cell carcinomas, and performed, right nephrectomy and left enucleation of the tumor. Pathological diagnosis was right renal cell carcinoma and left oncocytoma. To our knowledge only 5 previous cases of renal cell carcinoma associated with oncocytoma have been reported in Japan. Two cases were metachronous and three cases were unilateral and synchronous. This is the first reported case of bilateral, synchronous renal cell carcinoma and oncocytoma.     

Giant renal oncocytoma

We report the largest renal oncocytoma excised at the initial presentation and the second largest renal oncocytoma in published reports. Despite a tendency for renal oncocytomas to be relatively small and asymptomatic compared with renal cell carcinomas, these lesions cannot be reliably differentiated preoperatively. The variable nature of presentation and overlap of radiographic characteristics between these lesions complicates their clinical differentiation. The present case illustrates the difficulty in the preoperative diagnosis of even very large, enhancing renal masses and reinforces the inclusion of renal oncocytoma in the differential diagnosis of these lesions.     

肾色素性嗜酸细胞腺瘤(附一例报告)

对１例肾色素性嗜酸细胞腺瘤进行了光镜、电镜、免疫组化、图像分析和ＣＴ影像特征观察，结合文献就该肿瘤的临床病理特征作了探讨。     

Giant renal oncocytoma

Renal oncocytoma is a benign neoplasms arising from cells of the distal renal tubule. They acount for 3-7% of all renal tumors. most are incidental findings. Differential diagnosis with renal cells carcinoma is often difficult. Here we report a case of big renal oncocytoma as an incidental finding while performing an abdominal ultrasound in a patient with low abdominal pain. We also review the diagnostic an therapeutic approach in this kind of malignancies.     

Multicystic renal oncocytoma

The cystic variant of renal oncocytoma was defined by Ogden et al. (1986), who described a single case. A further case is described in the present communication, with notes on the clinical presentation, aspiration cytology, and histology of the surgical specimen. Follow-up over 3 years has been uneventful.     

Apropos of a case of renal oncocytoma with hepatic localization

A renal oncocytoma was treated by radical nephrectomy. Although it was considered benign, hepatic localizations were discovered seven years later. The authors discuss the problems of whether these were secondary metastatic lesions or a new development in the evolution of the disease.     

Aneurysms in renal oncocytoma

Renal oncocytoma is a nonaggressive lesion of the kidney that only recently has been defined as a separate entity pathologically. Clinically they are usually silent and are incidental findings on excretory urography. Sonography and computerized tomography demonstrate that it is a solid lesion, but it is only with angiography that a preoperative diagnosis can be suggested. The angiographic signs are summarized, and it is proposed that aneurysms in or associated with a mass now be included in the angiographic spectrum of oncocytoma.     

Bilateral multifocal renal oncocytoma

Renal oncocytoma is a rare benign tumor. Bilateral and multifocal renal oncocytoma has rarely been described in childhood. We report a 12-year-old girl who presented with massive left renomegaly and who was found to have bilateral cystic kidneys. A left nephrectomy was undertaken because of the renal enlargement, the radiological evidence of extensive disease, and to make a diagnosis. A diagnosis of multifocal oncocytoma was made after detailed histological examination.     

Molecular pathology of renal oncocytoma: A review

Differentiating renal oncocytoma from its renal cell carcinoma (RCC) mimics, particularly chromophobe RCC, can be difficult, especially when limited tissue is available for evaluation and requires sophisticated microscopic, ultrastructural and immunohistochemical evaluation. In this review, the relevant literature has been reviewed, and supporting data obtained by applying modern microarray‐based technologies are discussed with a focus on molecular pathology of renal oncocytoma. The high resolution whole‐genome DNA‐microarray based analyses excluded with all certainty the occurrence of small specific alterations. Renal oncocytomas are characterized by variable chromosomal patterns. The number of genes selected by global gene expression analyses and their usefulness in the diagnostic pathology based on immunohistochemical evaluation is far below the expectations. The conflicting staining patterns, together with the poor specificity of proposed antibodies, leads us to believe that these candidate immunomarkers might not help in the separation of these tumors. Applying DNA based tools might help in the diagnosis of renal oncocytoma with uncertain histology. However, only the combination of all available techniques could give reliable information.     

Two cases of renal oncocytoma

Two cases of renal oncocytoma are reported. These patients were a 67-year-old man and a 74-year-old man who had incidentally been indicated to have a right renal mass lesion by echography in other hospitals. In both cases, enhanced computed tomographic scan showed a low density renal mass. In selective renal angiogram of the two cases, a spoke-wheel configuration of vessels could be seen in one case, but there was no evidence of renal mass in another. Total nephrectomy was performed in each case. Two masses were pathologically diagnosed as oncocytoma, constructed of large eosinophilic cells with granular cytoplasm and small regular nuclei. These two patients have been well for more than 2 years after the surgery. These are the 25th and 26th cases of renal oncocytoma reported in Japan before December, 1988.     

Surgical repair of a celiac axis aneurysm and renal oncocytoma: A single case report

Visceral artery aneurysms are unusual lesions. However the frequency of diagnosis has increased in recent years as a result of increased utilization of arteriogram and computed tomographic (CT) scan. When diagnosed in conjunction with other syndromes, alternative treatment options can be utilized. The present case discusses a 67-year-old black male who presented with a right renal mass and a celiac artery aneurysm. The renal mass was diagnosed as an oncocytoma. This unique anatomy enabled us to perform a right nephrectomy in conjunction with a celiac artery aneurysmectomy with primary anastomosis between the right renal artery and common hepatic artery. This case demonstrates our approach to an unusual problem.