Abstract

BackgroundXp11.2 translocation renal cell carcinoma (RCC) is a rare variety of a kidney neoplasm. We report a case of bilateral Xp11.2 translocation RCC occurring metachronously and discuss this very rare entity with reference to the literature.Case presentationThe patient was a 56-year-old woman who presented with a right renal tumor. The patient had undergone left radical nephrectomy 7 years previously, which resulted in a histopathological diagnosis of clear cell RCC. Open right partial nephrectomy was performed under the presumptive diagnosis of recurrence of clear cell RCC. The present right renal tumor was pathologically diagnosed Xp11.2 translocation RCC. More than 70% of the tumor cells in the present right tumor were strongly positive for transcription factor E3 (TFE3) expression by immunohistochemical analysis with an anti-TFE3 antibody. A break-apart of the TFE3 genes in the bilateral tumors was identified by fluorescence in situ hybridization analysis. Real time-polymerase chain reaction analysis for the alveolar soft part sarcoma locus-TFE3 fusion gene was performed, which gave a positive result in the bilateral tumors. Pathological comparison of each of the tumors might lead to a final diagnosis of Xp11.2 translocation RCC occurring metachronously.ConclusionsWe present the bilateral Xp11.2 translocation RCC. A combination of immunohistochemical, cytogenetic and molecular biological approaches allowed the final diagnosis of such a rare RCC.

Highlights

  • Xp11.2 translocation renal cell carcinoma (RCC) is a rare variety of a kidney neoplasm

  • A combination of immunohistochemical, cytogenetic and molecular biological approaches allowed the final diagnosis of such a rare RCC

  • Melanosome and Melanin A staining have not been reported in Xp11.2 translocation RCC with alveolar soft part sarcoma locus (ASPL)-transcription factor E3 (TFE3) and PRCCTFE3 fusion

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Summary

Introduction

Xp11.2 translocation renal cell carcinoma (RCC) is a rare variety of a kidney neoplasm. Xp11.2 translocation RCC results from gene fusions between the transcription factor E3 (TFE3) gene located on chromosome Xp11.2 and various fusion partners. This unbalanced translocation results in fusion of the TFE3 gene, a member of the basic-helix-loop-helix family of transcription factors, on Xp11.2, to a novel gene named alveolar soft part sarcoma locus (ASPL) on 17q25 [3]. We present an extremely rare case of bilateral Xp11.2 translocation RCC occurring metachronously, and discuss the uncommon features of this case as determined by histopathological, cytogenetic and molecular approaches.

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