Carcinoid Tumours of the Kidney: A Clinico-Pathologic and 11q13 FISH Analysis
S Gobbo, M Brunelli, D Segala, I Alvarado-Cabrero, O Hes, G Pelosi, S Bersani, M Chilosi, F Menestrina, G Martignoni. University of Verona, Verona, Italy; Hospital de Oncología, Mexico, Mexico; Charles University Hospital, Pilsen, Czech Republic; European Institute of Oncology, Milan, Italy
Background: Renal carcinoid tumours rarely occur and a few small series have been reported with emphasis on clinico-pathological features. Little is known among cytogenetic abnormalities. Due to the high incidence of 11q13 riarrangements in neuroendocrine tumors arising in other human organs, we sought to assess 11q13 status in a serie of renal carcinoid tumours.
Design: Clinico-pathologic information on seven cases were recruited. Immunohistochemical and FISH analyses, using 11q13 break-apart locus specific probe, were performed.
Results: Patient age ranged from 35 to 74 years (average 56 y) (M:F; 5:2). Specimens consisted of radical nephrectomies with associated lymph node dissection in two cases. Five tumors were present in the left and 2 in the right kidney. Unifocal tumours ranged in size from 2.6 to 12 cm (average 5 cm). One tumour had history of a horseshoe kidney. Variety of patterns including tightly packed cords and trabeculae (80%) with minimal stroma, trabecular growth with prominent stroma, focal solid nests (15%), focal glandlike lumina (5%) were present. Calcifications were present in 3/7 cases. Mitoses measured 0-12 (mean 4) per 10 high-power fields. Necrosis was present in one case. Perirenal fat, renal sinus and renal vein invasions were documented in two cases whereas lymph-nodal metastases occurred in one. Hepatic and bone-marrow metastases were observed in two distinct cases. Carcinoid tumours were positive for synaptophysin (6/7) and CK8-18 (7/7) whereas chromogranin was expressed in 4 out of 7 cases. CK7 and CK20 were focally positive in 1 case; TTF-1 and DOG-1 were negative in all cases examined. Follow-up was available on 5 patients and ranged from 6 months to 4 years. One patient died of disease at 8 months after surgery and 1 patient died without disease at 4 years after surgery. Three were alive and well after 2 years. 11q13 riarrangements were observed in 3/7 cases (one breaked signals, one loss of q arm, one with gains of signals).
Conclusions: 1) synaptophysin represents the best immunohistochemical marker to document the endocrine nature of renal carcinoid tumours; 2) a few renal carcinoid tumours harbour 11q13 riarrangements in contrast with the neuroendocrine tumours arising from other organs.
Category: Genitourinary (including renal tumors)
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 169, Tuesday Morning