PAPILLARY RENAL CELL CARCINOMA: A SINGLE CENTER EXPERIENCE


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Yaprak Bayrak B.

HODJA AKHMET YASSAWI 6TH INTERNATIONAL CONFERENCE ON SCIENTIFIC RESEARCH, Lankaran, Azerbaijan, 13 - 15 May 2022, vol.1, pp.228-232

  • Publication Type: Conference Paper / Full Text
  • Volume: 1
  • City: Lankaran
  • Country: Azerbaijan
  • Page Numbers: pp.228-232
  • Kocaeli University Affiliated: Yes

Abstract

Introduction

Papillary type renal cell carcinoma (PRCC) is the most common type of renal carcinoma

(18.5%) after clear cell renal cell carcinoma. PRCC is usually histologically divided into 2

types, type 1 and type 2. Although there is no specific etiological cause, there are hereditary

causes. It is generally located in the renal cortex. Type 1 has a better prognosis than type 2. It

is more common in men. In this study, we aimed to retrospectively present the clinical and

histopathological prognostic data of patients who underwent partial/radical nephrectomy in

our clinic and were diagnosed with PRCC.

Material-Method

Twenty-four cases operated for PRCC between 2017 and 2021 were included in the study.

Results

Of the patients with papillary kidney tumors, 17 were male and 7 were female. The mean age

was 55.3. While partial nephrectomy was performed in 14 patients; 10 underwent radical

nephrectomy. 66.6% of tumors are alive; 33.3% of them were located in the left kidney.

While 16 patients were diagnosed with papillary type 1; Eight patients were diagnosed with

papillary type 2. According to the WHO/ISUP criteria, which is the nuclear rating, the most

common nuclear grade is 3 (45.8%); it was the least common 1 (4.1%). Tumor diameters

ranged from 13 mm to 200 mm (mean 57.5 mm). Necrosis was observed in 9 patients,

lymphovascular invasion in 2, tumor thrombus in the renal vein in 1, and perirenal fatty tissue

infiltration in 4; Invasion of renal sinus fatty tissue in 5, collecting system in 3, and Gerota's

fascia in 1 were detected. Sarcomatoid differentiation, continuity in surgical margins, and

lymph node metastasis were not observed in any of the cases.

Discussion/Conclusion

Renal cell carcinoma is not a single disease, but a heterogeneous group of various cancer

types. Each type has characteristic histological features with a corresponding genetic profile

and a different clinical course and response to therapy. PRCC accounts for about 15% of

kidney cancers. Histologically, it is characterized by the presence of fibrovascular nuclei with

tumor cells arranged in a papillary configuration. Sarcomatoid differentiation is seen in 5% of

cases.

Although there are 2 types of pathological PRCC, in the past, targeted therapies for papillary

carcinoma have been unsuccessful due to the lack of a clear understanding of the molecular

basis of these tumors. For this reason, molecular subtyping is being carried out today and it

has been revealed that type 2 PRCCs represent a heterogeneous group that can be divided into

additional subtypes depending on their genetic and molecular structure and reflects different

clinical course and prognosis.

Pathological evaluation and typing after total tumor resection is very important in terms of

prognosis and treatment management in these tumors.