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