Download PDF
CC BY-NC-ND 4.0 · J Lab Physicians
DOI: 10.1055/s-0043-1772850
Letter to Editor/Case Reports/Images

Multilocular Cystic Renal Neoplasm of Low Malignant Potential in a Patient with Chronic Pyelonephritis and End-Stage Renal Disease: A Rare Case Report

Rupinder Kaur 
1   Department of Pathology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, Haryana, India
,
Vijay Shrawan Nijhawan 
1   Department of Pathology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, Haryana, India
,
Ayushi Kediya 
1   Department of Pathology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, Haryana, India
,
Vishesh Dhawan 
1   Department of Pathology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, Haryana, India
,
Sahil Singhal 
1   Department of Pathology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, Haryana, India
,
Ashmita Joshi 
1   Department of Pathology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, Haryana, India
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Multilocular cystic renal neoplasm of low malignant potential (MCNLMP) is a rare subtype of clear cell carcinoma having an excellent prognosis. These tumors exhibit distinct morphology and comprises of multiple cysts separated by thin septa lined by clear cells with no expansile growth. These cysts, though rare in a setting of chronic pyelonephritis and end-stage renal disease, are usually diagnosed on radiography using the Bosniak classification. But in certain situations where cysts are not visible radiologically, a final diagnosis is made with the help of histopathology and immunohistochemistry only. We, hereby, report such a rare incidental case of MCNLMP diagnosed on histopathology in a nephrectomy specimen of an elderly male with chronic pyelonephritis and end-stage renal disease.

Keywords

Bosniak - cystic disease - end-stage renal disease - pyelonephritis

Authors' Contributions

R.K., V.S.N., and V.D. conceptualized the study. A.K., V.D., S.S., and A.J. helped in data curation. R.K., V.S.N, and V.D. helped in critical and intellectual evaluation. R.K., V.S.N., V.D., and A.K. drafted the manuscript. All authors have approved the manuscript.


Financial Support

None.




Publication History

Received: 31 May 2023

Accepted: 01 August 2023

Article published online:
28 August 2023

© 2023. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Moch H, Amin MB, Berney DM. et al. The 2022 World Health Organization classification of tumours of the urinary system and male genital organs—part A: renal, penile, and testicular tumours. Eur Urol 2022; 82 (05) 458-468
    CrossrefPubMedGoogle Scholar
  • 2 Montinori R, Cheng L, Lopez-Beltran A. et al. Multilocular cystic renal neoplasm of low malignant potential. World Health Organ Classif Tumours 2016; •••: 22
    Google Scholar
  • 3 Tickoo SK, dePeralta-Venturina MN, Harik LR. et al. Spectrum of epithelial neoplasms in end-stage renal disease: an experience from 66 tumor-bearing kidneys with emphasis on histologic patterns distinct from those in sporadic adult renal neoplasia. Am J Surg Pathol 2006; 30 (02) 141-153
    CrossrefPubMedGoogle Scholar
  • 4 Schieda N, Davenport MS, Krishna S. et al. Bosniak classification of cystic renal masses, version 2019: a pictorial guide to clinical use. Radiographics 2021; 41 (03) 814-828
    CrossrefPubMedGoogle Scholar
  • 5 Tsuzuki T, Iwata H, Murase Y, Takahara T, Ohashi A. Renal tumors in end-stage renal disease: a comprehensive review. Int J Urol 2018; 25 (09) 780-786
    CrossrefPubMedGoogle Scholar
  • 6 Tantisattamo E, Elam A, Cobb J, Ellis CL, Bailey JL. No tumor-free waiting period after treatment of multilocular cystic renal cell carcinoma: a new case and review of the literature. Am J Nephrol 2014; 40 (02) 151-156
    CrossrefPubMedGoogle Scholar
  • 7 Kesari M, Agarwal S, Patil Y, Bhattacharya I, Dholpure M. Rare case of multilocular cystic renal neoplasm of low malignant potential with chronic pyelonephritis. J Clin Diagn Res 2021;15(08):
    Google Scholar
  • 8 Diolombi ML, Cheng L, Argani P, Epstein JI. Do clear cell papillary renal cell carcinomas have malignant potential?. Am J Surg Pathol 2015; 39 (12) 1621-1634
    CrossrefPubMedGoogle Scholar
  • 9 Kim SH, Park WS, Chung J. SETD2, GIGYF2, FGFR3, BCR, KMT2C, and TSC2 as candidate genes for differentiating multilocular cystic renal neoplasm of low malignant potential from clear cell renal cell carcinoma with cystic change. Investig Clin Urol 2019; 60 (03) 148-155
    CrossrefPubMedGoogle Scholar
  • 10 Pitra T, Pivovarcikova K, Alaghehbandan R. et al. A comprehensive commentary on the multilocular cystic renal neoplasm of low malignant potential: a urologist's perspective. Cancers (Basel) 2022; 14 (03) 831
    CrossrefPubMedGoogle Scholar
  • 11 Li T, Chen J, Jiang Y. et al. Multilocular cystic renal cell neoplasm of low malignant potential: a series of 76 cases. Clin Genitourin Cancer 2016; 14 (06) e553-e557
    CrossrefPubMedGoogle Scholar
  • 12 Tretiakova M, Mehta V, Kocherginsky M. et al. Predominantly cystic clear cell renal cell carcinoma and multilocular cystic renal neoplasm of low malignant potential form a low-grade spectrum. Virchows Arch 2018; 473 (01) 85-93
    CrossrefPubMedGoogle Scholar
  • 13 Bhatt JR, Jewett MA, Richard PO. et al. Multilocular cystic renal cell carcinoma: pathological t staging makes no difference to favorable outcomes and should be reclassified. J Urol 2016; 196 (05) 1350-1355
    CrossrefPubMedGoogle Scholar
  • 14 Nassir A, Jollimore J, Gupta R, Bell D, Norman R. Multilocular cystic renal cell carcinoma: a series of 12 cases and review of the literature. Urology 2002; 60 (03) 421-427
    CrossrefPubMedGoogle Scholar
  • 15 Gong K, Zhang N, He Z, Zhou L, Lin G, Na Y. Multilocular cystic renal cell carcinoma: an experience of clinical management for 31 cases. J Cancer Res Clin Oncol 2008; 134 (04) 433-437
    CrossrefPubMedGoogle Scholar
  • 16 Westerman ME, Cheville JC, Lohse CM. et al. Long-term outcomes of patients with low grade cystic renal epithelial neoplasms. Urology 2019; 133: 145-150
    CrossrefPubMedGoogle Scholar
  • 17 Suzigan S, López-Beltrán A, Montironi R. et al. Multilocular cystic renal cell carcinoma: a report of 45 cases of a kidney tumor of low malignant potential. Am J Clin Pathol 2006; 125 (02) 217-222
    CrossrefPubMedGoogle Scholar
  • 18 Murshed KA, Akhtar M, Ben-Gashir M. Multilocular cystic renal neoplasm of low malignant potential extending into the perinephric adipose tissue. Hum. Pathol.: Case Rep. 2019; 17: 200305
    Google Scholar
  • 19 Aubert S, Zini L, Delomez J, Biserte J, Lemaitre L, Leroy X. Cystic renal cell carcinomas in adults. Is preoperative recognition of multilocular cystic renal cell carcinoma possible?. J Urol 2005; 174 (06) 2115-2119
    CrossrefPubMedGoogle Scholar