Renal oncocytoma associated with necrotizing glomerulonephritis

A case of renal oncocytoma associated with focal segmental necrotizing glomerulonephritis is described. The patient showed haematuria, mild proteinuria and arterial hypertension; the diagnosis was made after right nephrectomy performed because of the presence of a renal mass. A severe re-activation of the glomerulonephritis was observed 15 months after the nephrectomy and a steroid and immunosuppressive therapy was started. Our case is the first reported in which the removal of renal oncocytoma is not followed by the disappearance of renal symptoms, as currently reported in literature, suggesting that the two diseases are not always related.     

Oncocytoma associated with acquired cystic disease of kidney (ACDK): a case report

A case of renal oncocytoma associated with acquired cystic disease of kidney (ACDK) in a 56-year-old man is reported. He had received hemodialysis for 15 years because of chronic renal failure. Computed tomography (CT) was performed because of distention in the upper abdomen, revealing a right renal tumor. He underwent laparoscopic right nephrectomy, and was diagnosed with renal oncocytoma. There have been reported 8 cases of renal oncocytoma in hemodialysis patients, and our case was the third one associated with ACDK in the literature.     

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.     

Renal oncocytoma with synchronous contralateral renal cell carcinoma

A 60-year-old male was admitted with bilateral renal masses with a diameter of 50 mm (right kidney), and 15 mm (left kidney) found incidentally by computed tomography. Renal angiography demonstrated neovascularization in the lower pole of the right kidney, but no remarkable findings in the left kidney. We could not deny the possibility of bilateral renal cell carcinoma. Right radical nephrectomy and left partial nephrectomy were performed. The histopathological finding revealed diagnosis of right papillary renal cell carcinoma and left oncocytoma. To our knowledge, this is the third case of renal oncocytoma with synchronous contralateral renal cell carcinoma reported in Japan.     

Renal oncocytoma associated with tuberous sclerosis: report of a case

A case of a renal oncocytoma associated with tuberous sclerosis in a 31-year-old woman is reported. She displayed many characteristic skin features of tuberous sclerosis but no central nervous symptoms. Although she complained of dysmenorrhea and hypermenorrhea, she had no complaints related to the kidney. A left renal tumor was discovered incidentally during preoperative examination for gynecologic disease and left nephrectomy was performed. Histologically, the tumor was shown to be a typical renal oncocytoma. This is supposed to be the first case of renal oncocytoma associated with tuberous sclerosis in Japan.     

Renal oncocytoma with bilateral synchronous renal cell carcinoma in a patient undergoing long-term hemodialysis

Abstract:   We report a case of bilateral synchronous renal cell carcinoma and renal oncocytoma in a 56-year-old male who had been treated with hemodialysis for 32 years. Because anemia gradually worsened, computed tomography and magnetic resonance imaging were carried out and revealed bilateral renal tumors within acquired cystic disease of the kidney. Bilateral nephrectomy was carried out, and the patient was diagnosed with multiple renal cell carcinomas and a single renal oncocytoma. To our knowledge, this is the first reported case of renal oncocytoma with synchronous renal cell carcinoma in a patient undergoing long-term hemodialysis.     

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.     

A case of renal oncocytoma

A case of renal oncocytoma is reported. A 56-year-old woman was admitted with the complaint of an abdominal mass. Right transabdominal nephrectomy was performed on January 23, 1984. The resected kidney weighed 262 g and contained a well-demarcated 5 X 5 X 4 cm tumor in the middle portion. The cross section of the tumor was tan-brown. Light microscopic examination disclosed that the greater part of the tumor was composed of cells with abundant, and finely granular eosinophilic cytoplasm and with moderate nuclear pleomorphism. Electron microscopic examination confirmed that the cytoplasm had numerous mitochondria and few other organelles. According to these findings, the tumor was diagnosed as renal oncocytoma. Furthermore, it is noteworthy that in this case there were tubular arrangement of the cells resembling proximal renal tubules in a focal area and a group of cells with considerable nuclear atypia and hyperchromatism in another area. The patient has been well without any local recurrence or distant metastasis ten months after the operation. In addition, fourteen cases of renal oncocytoma in Japan, including the present case, are reviewed.     

IgA glomerulonephritis in a patient with renal cell carcinoma

A case of IgA glomerulonephritis associated with renal cell carcinoma is reported. A 61-year-old male was admitted because of a left renal mass and proteinuria. A diagnosis of renal cell carcinoma was made by computed tomography and angiography. Left radical nephrectomy was performed. Microscopically, the tumor tissue revealed renal cell carcinoma of the clear cell type. Light, immunofluorescent and electron microscopic examinations demonstrated characteristic features of IgA glomerulonephritis. The proteinuria and hematuria disappeared 8 months after removal of the tumor. These findings suggest that the IgA glomerulonephritis in our patient may have been attributable to an immune response against the renal cell carcinoma.     

Case report of a symptomatic giant renal oncocytoma

Renal oncocytomas are benign tumours, often asymptomatic, and picked incidentally on radiological imaging. We present a case report of a symptomatic giant renal oncocytoma in a 61-year old man having lower back/right flank pain. A large right renal mass was identified on abdominal CT scan. Radiological features were not sufficient to differentiate this lesion from renal cancer. Right radical nephrectomy was performed. Typical features of oncocytoma, without evidence of malignancy, were seen on histological examination of the specimen. In this report, we discuss literature review of radiological, genetic, and pathological characteristics of renal oncocytoma.     

Renal oncocytoma in Taiwan

BACKGROUND: Renal oncocytoma has been repeatedly reported in Western countries, but only a few cases have been reported in Eastern countries. This study aims to review the clinical course of renal oncocytoma in an Eastern country such as Taiwan. MATERIALS AND METHODS: Sixteen cases of renal oncocytoma seen between 1987 and 2002 at Chang Gung Memorial Hospital, Taipei, Taiwan, were studied. RESULTS: Preoperatively, all patients were diagnosed to have renal cell carcinoma, following various radiologic studies. Perioperatively, frozen sections of three patients indicated renal oncocytoma in two and renal cell carcinoma in one. Renal oncocytoma has marked similarities to renal cell carcinoma, according to various radiologic, cytologic, and pathological investigations, so an accurate diagnosis is difficult to achieve, either preoperatively or perioperatively. Therefore, rather than being treated with partial nephrectomy, all patients were treated aggressively with unilateral radical nephrectomy. Postoperatively, all 16 patients were followed up, from 12 to 189 months, with a mean of 58.7 months. Notably, all patients survived with no evidence of tumor recurrence. CONCLUSIONS: The experience in Taiwan is generally that renal oncocytoma behaves benignly, as reported in other areas. The excellent prognosis associated with this tumor appears to indicate that partial nephrectomy may suffice for removing the tumor, while sparing other unaffected renal parenchyma.     

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.     

肾嗜酸细胞瘤的诊治(附12例报告)

目的：探讨肾嗜酸细胞瘤的诊断和治疗。方法：报告12例肾嗜酸细胞瘤，结合文献资料复习讨论。结果：8例肿瘤行肾癌根治性切除，1例行肾输尿管切除术，3例行肾部分切除术。随访5个月～6年，均无转移或复发。结论：肾嗜酸细胞瘤系肾脏的良性倾向肿瘤，瘤体中心区星形瘢痕是本病的特征性影像学改变。术前诊断较困难，诊断主要依据病理组织学。治疗以保肾丁术首选，但应密切随访，因为本病易并发肾恶性肿瘤。     

Renal Oncocytoma in Taiwan

Background. Renal oncocytoma has been repeatedly reported in Western countries, but only a few cases have been reported in Eastern countries. This study aims to review the clinical course of renal oncocytoma in an Eastern country such as Taiwan. Materials and Methods. Sixteen cases of renal oncocytoma seen between 1987 and 2002 at Chang Gung Memorial Hospital, Taipei, Taiwan, were studied. Results. Preoperatively, all patients were diagnosed to have renal cell carcinoma, following various radiologic studies. Perioperatively, frozen sections of three patients indicated renal oncocytoma in two and renal cell carcinoma in one. Renal oncocytoma has marked similarities to renal cell carcinoma, according to various radiologic, cytologic, and pathological investigations, so an accurate diagnosis is difficult to achieve, either preoperatively or perioperatively. Therefore, rather than being treated with partial nephrectomy, all patients were treated aggressively with unilateral radical nephrectomy. Postoperatively, all 16 patients were followed up, from 12 to 189 months, with a mean of 58.7 months. Notably, all patients survived with no evidence of tumor recurrence. Conclusions. The experience in Taiwan is generally that renal oncocytoma behaves benignly, as reported in other areas. The excellent prognosis associated with this tumor appears to indicate that partial nephrectomy may suffice for removing the tumor, while sparing other unaffected renal parenchyma.     

Proliferative glomerulonephritis associated with reflex nephropathy.

A case of unilateral reflux nephropathy treated by initial ureteral reimplantation and subsequent nephrectomy is reported. Pathologic examination of the resected kidney showed unsuspected proliferative glomerulonephritis. The relationship of chronic atrophic pyelonephritis, as seen in reflux nephropathy, and glomerulonephritis is discussed to emphasize that reflux nephropathy does not exclude the presence of other renal disease that may complicate the long-term care of the patient.     

Renal oncocytoma: diagnostic and therapeutic aspects

Renal oncocytoma is one of the most unusual benign lesions, which presents as a complicated mass resulting in a diagnostic and therapeutic dilemma. A new case of renal oncocytoma in a 13-year-old boy is presented. The clinocopathologic features of this rare entity are discussed, with special emphasis on diagnosis and treatment. There are no specific presumptive clinical and laboratory findings, including tumor markers, ploidy analysis, and imaging techniques that distinguish oncocytoma from other renal masses. The most important diagnostic aid is to bear this entity in mind when a child presents with an unexplained renal mass. Frozen section biopsies followed by partial nephrectomy are mandatory for the appropriate treatment after excluding bilateral or multifocal occurrence.     

Renal oncocytoma—bilateral,multifocal

One hundred thirteen cases of “grade I renal oncocytoma” are reported from several centers. All centers report absence of associated metastatic disease. In the present review of 219 radical nephrectomy specimens, 11 renal oncocytomas were identified, an incidence of 5 per cent. No diagnostic angiographic features could be identified. Multifocal potential is exemplified by study of a bilateral case and 2 cases of 2 independent oncocytomas in the same kidney. The fine histologic criteria distinguishing oncocytoma from malignant renal tumors suggest that the oncocytomas may have the potential of malignant degeneration. The possible “premalignant classification” of oncocytomas and the lack of dependable diagnostic features radiographically force the management to be the same as for Stage I renal carcinoma. The prognostic information available after histologic definition of renal oncocytoma is valuable.     

Oncocytoma and synchronous urothelial carcinoma in same kidney: previously unreported association

Many cases of histologically distinct renal tumors occurring coincidentally in the same patient have been reported. We report the first case of a benign oncocytoma and a urothelial carcinoma occurring synchronously in the same kidney in a man who underwent radical nephrectomy for a suspicious renal mass. The patient subsequently underwent distal ureterectomy.     

Preoperative diagnosis of renal oncocytoma and treatment possibilities

We report 2 cases of renal oncocytoma and review the literature. A number of radiological, cytological and ultrastructural differential features of oncocytoma that are known today make preoperative diagnosis of this tumour possible. Analysis of the reported cases allows to conclude that oncocytomas are of universally benign character with a very good prognosis. Metastases have not been documented. Thus we suggest that many patients with oncocytoma could be spared the operation of nephrectomy. Partial kidney resection or heminephrectomy are to be preferred with solitary oncocytomas of a moderate size.     

2例肾嗜酸细胞瘤的诊治体会

目的：探讨肾嗜酸细胞瘤的诊断和治疗。方法：报告2例肾嗜酸细胞瘤，结合文献资料复习讨论。结果：肿瘤均位于左肾中上段，行根治性左肾切除及单纯左肾切除。肿瘤切面灰褐色或黄褐色，质软；镜检瘤细胞均呈圆形或类圆形，胞质富含浓染嗜酸颗粒，核泡状，瘤细胞呈巢状、管状、微囊状或卵圆形片状排列，瘤组织中心部可见玻璃样变无细胞区；免疫组化：bcl-2( )、PCNA( )或(-)。结论：肾嗜酸细胞瘤系肾脏的良性倾向肿瘤，术前诊断较困难，瘤体中心区星形瘢痕是本病的特征性影像学改变，本病可能潜在恶性变，治疗以保肾手术首选，但应密切随访。