Abstract
Clear cell papillary renal cell carcinoma (CCP-RCC) is a recently described, relatively uncommon variant of renal cell carcinoma (RCC) with a reported incidence of 4.1%. Thought to only arise in those with end stage renal disease, CCP-RCC is increasingly identified in those without renal impairment. CCP-RCCs have unique morphologic, genetic, and immunohistochemical features distinguishing them from both conventional clear cell renal cell carcinomas and papillary renal cell carcinomas. Immunohistochemically, these tumors are positive for CK7 and negative for CD10 and racemase. This is in contrast to conventional cell renal cell carcinomas (CK7 negative, CD10 positive) and papillary cell carcinomas (CK7, CD10, and racemase positive). These tumours appear to be indolent in nature, with no current documented cases of metastatic spread. We present the case of a 42-year-old female who presented with an incidental finding of a renal mass that on a core biopsy was reported as clear cell carcinoma, Fuhrman grade 1. She subsequently underwent a radical nephrectomy and further histological examination revealed the tumor to be a clear cell papillary renal cell carcinoma, Fuhrman grade 1.
Highlights
The World Health Organisation in 2004 has classified renal cell carcinoma into the various histological subtypes [1]
We present a case of a 42-year-old female who was found to have an incidental renal mass, which, on histological examination of the excised specimen, was revealed to be a clear cell papillary carcinoma, a relatively uncommon variant of renal cell carcinoma
A core biopsy of the left kidney was reported as a Fuhrman grade 1, clear cell renal cell carcinoma (Figure 1)
Summary
The World Health Organisation in 2004 has classified renal cell carcinoma into the various histological subtypes [1]. More recently the International Society of Urological Pathologists Vancouver Classification recommended including clear cell papillary renal cell carcinoma (amongst others) in the classification [5]. These tumors consist of a single layer of cells with clear cytoplasm organized in tubular, cystic, and papillary patterns. They are positive for CK7 and negative for CD10 and racemase. An appreciation of new histological subtypes of RCC, such as clear cell papillary renal cell carcinoma, and their biological behavior, will assist clinicians to advise patients on the safe and appropriate management of such tumors
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