Chromophobe renal cell carcinoma with clear cell features; a case report with review of literature

Anjum Ara,Shagufta Shahin,Shahid A Siddiqui,Mohammad Saleem,Kafil Akhtar

doi:10.34172/jnp.2021.34

Abstract

Renal cell carcinoma (RCC) accounts for 3.0% of all malignant lesions of the human body. The World Health Organization (WHO) has classified renal malignant epithelial tumors as-clear cell, papillary, chromophobe and collecting duct RCCs and benign tumors as oncocytoma and angiomyolipoma. Chromophobe RCC is a distinct and rare variant of RCC. It shows equal preponderance in males and females and most commonly presents in the 6th decade of life. Because of overlapping clinical and microscopic features in different variants of RCC and considering the significant implications of the subtypes in the prognosis and treatment of these tumors, the histological classification of RCCs is extremely important. Here we report a case of a 56-year-old male, who presented with urinary complaints of hematuria, and was diagnosed as chromophobe RCC with clear cell features on histopathology and radiographic imaging.

Highlights

Renal cell carcinomas (RCCs) are the seventh most common histological type of cancer in the western world and have shown an increasing prevalence [1,2]
Chromophobe RCC is a rare variant of RCC but it presents at an earlier stage and has a better prognosis than conventional RCC
We present a case of a 56-year-old male, who presented with urinary complaints of hematuria and was diagnosed as chromophobe RCC with predominating clear cell features

Summary

Introduction

Renal cell carcinomas (RCCs) are the seventh most common histological type of cancer in the western world and have shown an increasing prevalence [1,2]. The incidence of clear cell RCC (70-90%), papillary RCC (10%-15%) and chromophobe RCC is 3-5%, based on 2016 WHO classification of renal tumors [3]. We present a case of a 56-year-old male, who presented with urinary complaints of hematuria and was diagnosed as chromophobe RCC with predominating clear cell features. Case Report A 56-year-old male presented to the surgery outpatient department with chief complaint of hematuria for the last three months. CT scan was performed, which showed a left solid homogenous renal tumor of 5×4 cm in size. The tumor cells had sharply defined borders and abundant pale granular to acidophilic cytoplasm with perinuclear clearing. Immunoexpression of chromophobe RCC component showed diffuse cytoplasmic positivity for CK7 (Figure 2A) and the clear cell foci showed CD10 membranous positivity (Figure 2B). Our patient was administered immunotherapy, (Soratinib 400 mg twice daily) and is doing well after 12 months postoperative follow up period

Findings

Discussion

Conclusion