Bellini duct carcinoma of the kidney: a case report

This is a report of a case of Bellini duct carcinoma of the kidney. A 72-year-old male was admitted to our hospital for the treatment of left renal tumor. The abdominal computed tomographic scan showed hypoattenuating tumor with infiltrative spread into the renal cortex. The renal angiography revealed a hypovascular tumor. Left nephro-ureterectomy was performed because transitional cell carcinoma was suspected in the frozen section. The gross examination revealed an infiltrating white-gray tumor centered in the renal medulla. No hemorrhage was discovered, but partial necrosis was found. Capsular infiltration was not seen. Histologically, tumor cells were mostly scattered and partially showed a papillary and tubular structure. Cells had abundant eosinophilic cytoplasm and large irregular nuclei. Immunohistochemical studies revealed positive reactions for cytokeratin, epithelial membrane antigen and ulex europaeus agglutinin. We diagnosed this patient with Bellini duct carcinoma. He died due to drastic progression of metastasis from carcinoma two months postoperatively.     

Bellini duct carcinoma of the kidney: a case report

We report a case of Bellini duct carcinoma. A 65-year-old man visited our hospital because of an asymptomatic right renal mass directed by ultrasonography and computed tomography in an other hospital. His urine cytology was negative. The tumor showed a minimal enhancement in computed tomography. Under the preoperative diagnosis of an atypical right renal tumor, laparoscopic right radical nephrectomy was performed. The tumor is 50 mm in diameter and the surface was grayish-white in color. The histopathological diagnosis was low-grade Bellini duct carcinoma. Immunohistostaining revealed positive staining for UA-1 and EMA in the tumor tissue. No evidence of recurrence or metastasis was noted 36 months after surgery without any adjuvant therapy.     

Bellini duct carcinoma: a case report

A 53-year-old man was admitted to our hospital for the extensive examination and treatment of suspicioun of right renal pelvic tumor. Retrograde pyelography (RP), computed tomography (CT) and magnetic resonance imaging (MRI) showed a space-occupying lesion, about 2 cm in diameter, spread from the renal parenchyma to the renal pelvis. Right nephroureterectomy was performed because transitional cell carcinoma was suspected from the histopothology of the frozen section. The gross examination revealed a white tumor in the upper pole, protruding into the renal pelvis with hemorrhagic necrosis. Histological examination showed Bellini duct carcinoma of the papillary type. He received adjuvant combination chemotherapy with M-VAC (Methotrexate, vinblastine, doxorubicin, cisplatin). He has been alive without evidence of recurrence since the surgery.     

Bellini duct carcinoma of the kidney.

Human epithelial cells of the kidney present a wide spectrum of cytological and histological variation. The normal epithelium of the kidneys also includes a number of morphologically and functionally different cell types which are arranged along the nephrons and collecting ducts. Although renal carcinoma can involve any type of renal cell, the most common is renal cell carcinoma of the proximal tubuli. Here, we present the case of a 65-year-old Japanese patient with a renal cell carcinoma arising from Bellini duct epithelial cells. State-of-the-art techniques were used to establish the diagnosis and histogenesis of this renal cell carcinoma.     

Bellini duct carcinoma of the kidney.

We report a very rare case of Bellini duct carcinoma originating from the collecting tubules of the kidney. A left renal tumor was detected during a health examination and radical nephrectomy was performed. Histological examination showed papillary adenocarcinoma. By means of immunohistochemical methods, we felt that the tumor was a renal carcinoma of Bellini duct origin.     

Bellini duct (collecting duct) carcinoma of the kidney

Carcinoma of the collecting ducts, or Bellini carcinoma, is a rare renal tumour and, unlike most renal cell carcinomas, it derives from distal tubules. It displays highly aggressive behaviour and has a poor prognosis. In this study, the authors present three cases which they observed over the past three years.     

Synchronus renal cell carcinoma and Bellini duct carcinoma: a case report on a rare coincidence

Bellini duct carcinoma or collecting duct carcinoma (CDC) is a rare but aggressive primary renal neoplasm. The coexistence of two synchronous neoplasms in the same kidney is highly infrequent. As a result, it is hardly surprising that there are no references to renal cell carcinoma (RCC) combined with CDC of the same kidney in the literature. Histology and immunohistochemistry are important tools for differentiating between the two types of tumors involved. We present the first case of a synchronous occurrence of RCC and CDC of the same kidney.     

A case of Bellini duct carcinoma with giant hydronephrosis

We report a case of Bellini duct carcinoma with giant hydronephrosis. A 56-year-old man was referred with the chief complaint of gross hematuria. The intravenous pyelography showed a huge right renal contour and non-functioning kidney. The abdominal computed tomographic scan and magnetic resonance imaging demonstrated giant hydronephrosis. Percutaneous urinary cytology obtained in the direct pyelography was class V. Right total nephro-ureterectomy was performed. Punctured fluid volume was 1,010 ml during the operation. Histological and immunohistochemical analysis revealed the collecting duct carcinoma of the kidney. Three months later, multiple bone metastases had appeared. He was treated by the combination chemotherapy of gemcitabine and paclitaxel, but lung and liver metastases developed. The patient died of cancer 12 months later. This case was considered to be Bellini's duct carcinoma as its features had poor prognosis and image findings infiltrating from medulla to cortex with the total enlargement of the kidney. To our knowledge there has been no case found like these atypical imaging findings.     

A case of collecting duct carcinoma (Bellini duct carcinoma) producing carcinoembryonic antigen

We report a case of collecting duct carcinoma (Bellini duct carcinoma) producing carcinoembryonic antigen (CEA). A 61-year-old man visited our hospital because of a left renal mass detected by ultrasonography in an other hospital. Computed tomography showed a low density tumor measuring about 3 cm in the left kidney. Angiography demonstrated a hypovascular tumor. The serum level of CEA was increased to 20 ng/ml. (normal < 7 ng/ml). Left radical nephrectomy was performed. Histological examination revealed collecting duct carcinoma with papillary growth (T1aN1M0). Cancer cells showed a positive immunohistochemical staining for CEA. Under a diagnosis of CEA-producing collecting duct carcinoma of the left kidney, the patient underwent systemic chemotherapy (M-VAC). The serum level of CEA decreased to the normal level after the nephrectomy, but six months postoperatively, metastatic bone tumor at the left pelvic bone was revealed on the plain film and at the same time, the CEA level was increased again.     

A case of Bellini collecting duct carcinoma with hypercalcemia in a young adult

A 25-year-old man presented to a local clinic with right flank pain and gross hematuria. Computed tomography revealed the right renal tumor and he was referred to our hospital. Laparoscopic radical nephrectomy was performed and diagnosis of Bellini collecting duct carcinoma was made pathologically. Adjuvant therapy with interferon-α, followed by a gemcitabine and cisplatin-based regimen of chemotherapy was performed, but the disease progressed. Sunitinib was started 14 months after the operation. After one course of sunitinib, mental status was altered due to hypercalcemia (serum calcium level was 18.6 mg/dl and PTH-rP was 3.7 pmol/l). Level of consciousness recovered along with decreasing serum calcium level, but he died of multiple organ dysfunction 17 months after the operation. Autopsy showed liver, bone, lymph node, mediastinum and left adrenal tumor metastases.     

Collecting duct carcinoma (Bellini duct carcinoma) of the kidney with tumor extension into the inferior vena cava]

We report a case of collecting duct carcinoma (Bellini duct carcinoma) of the left kidney accompanied with a tumor thrombus in the inferior vena cava and the lymph node metastasis. A 69-year-old male presented with gross hematuria and left flank dullness. Computed tomography revealed an isodensity tumor in the left kidney with tumor extension into the inferior vena cava and the regional lymph node swelling. The T1-weighted magnetic resonance image displayed a slightly heterogeneous low-intensity-mass. Renal angiography revealed a hypervascular tumor. We performed left radical nephrectomy with tumor thrombectomy and regional lymphadenectomy. Histopathological examination revealed a collecting duct carcinoma (pT3bN1M0V2a). Seven months after surgery, multiple metastates in bone and liver developed. Then we performed systemic chemotherapy consisting of methotrexate and cisplatin. However, the patient died from the carcinoma 10 months postoperatively.     

Collecting duct carcinoma of the kidney: a case report and review of the literature.

Collecting duct carcinoma of the kidney is unique and rarely reported. The histological and ultrastructural characteristics of this tumor are well described in the pathological literature. However, there are few reports documenting the clinical presentation and long-term prognosis in patients with this unusual malignancy. Collecting duct carcinoma arises from the epithelium of the collecting tubules within the medulla and secondarily invades the renal cortex. The tumor occurs in a younger age group than is typical for renal cell carcinoma and most patients appear to have metastatic disease at presentation. We describe a case of this uncommon tumor and review the literature.     

Bellini duct carcinoma: Review of diagnosis and management

Aim: To review the world literature on the histogenesis, diagnosis and management of Bellini duct carcinoma and to suggest a possible clinical algorithm to assist in their identification and appropriate therapeutic strategies.Methods: A medline review of all reported cases of Bellini duct carcinoma was carried out from the Pubmed using the keywords collecting duct carcinoma, Bellini duct carcinoma, medullary renal carcinoma and renal cancers.Results: 40 worldwide reported cases of Bellini duct carcinoma were found. We analyzed their salient pathological, diagnostic and management strategies. A simplistic approach and a clinical algorithm has been suggested to enable their rapid identification, diagnosis and management.     

Sarcomatoid carcinoma of the kidney: a case report

Sarcomatoid carcinoma of the kidney is an uncommon tumor associated with a very poor prognosis. Because this tumor can be occasionally difficult to distinguish from renal sarcoma, immunohistochemistry and electronmicroscopy are sometimes necessary for diagnosis. Therapy is actually essentially surgical because if adjuvant therapies should follow radical nephrectomy, no standardized regimen has been at present defined.     

Collecting duct (Bellini duct) renal cell carcinoma: a nationwide survey in Japan

PURPOSE: Collecting duct carcinoma, a rare type of renal cell carcinoma, remains poorly understood. To analyze the nature of collecting duct carcinoma a retrospective survey was performed in Japan. MATERIALS AND METHODS: This survey was done from August 2001 to April 2003. A total of 281 institutions throughout Japan were requested to document all cases of collecting duct carcinoma. All pertinent clinical information was compiled, including patient age, sex, mode of presentation, evaluation modality, preoperative laboratory data, surgery type, macroscopic and microscopic findings, and survival data. Two urological pathologists reviewed microscopic slides of all tumor specimens to confirm collecting duct carcinoma. RESULTS: Two pathologists confirmed collecting duct carcinoma in 81 of the 120 cases documented as collecting duct carcinoma. Mean patient age was 58.2 years and males comprised 71.6% of all patients. The mode of presentation was classified as symptomatic in 65.4% of cases, incidental in 24.7% and not available in 9.9%. Regional lymph node metastasis was histologically detected in 44.2% of patients who underwent lymph node dissection, while 32.1% of the population had distant metastasis at presentation. Although postoperative adjuvant therapy against metastasis or recurrence was performed in 25 patients, no obvious responses were identified except in 1 with lung metastases, who showed a partial response to combined gemcitabine and carboplatin therapy. At a median followup of 15 months 1, 3, 5 and 10-year disease specific survival was 69.0%, 45.3%, 34.3% and 13.7%, respectively. CONCLUSIONS: We report what is to our knowledge the largest known series of collecting duct carcinoma. Since advanced or recurrent collecting duct carcinoma is resistant to standard treatment modalities, new treatment strategies are needed for advanced collecting duct carcinoma.     

A case of Bellini duct carcinoma producing granulocyte colony-stimulating factor (G-CSF)

A case of Bellini duct carcinoma producing granulocyte colony-stimulating factor (G-CSF) is reported. The patient was a 75-year-old female with the chief complaint of appetite loss. Abdominal ultrasonography and abdominal computed tomography revealed left renal pelvic tumor. Left radical nephrouretrectomy was performed. The histopathological report showed Bellini duct carcinoma. Immunohistochemical staining using the anti-G-CSF antibody showed positive staining in the cancer cells. Preoperatively, the white blood cell count and serum G-CSF concentration were elevated to 34,100/microliter and 334 pg/ml respectively. After operation these values became normal. However, these values were elevated again and CT scan revealed a left pulmonary metastasis 3 months after the operation. In spite of chemotherapy, she died of brain metastases 7 months after the operation.