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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2009  |  Volume : 20  |  Issue : 3  |  Page : 462-464
Renal carcinoid tumor


1 Transplant Research Center, Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
2 Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran

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   Abstract 

Primary renal carcinoid is a rare tumor, until now less than 50 cases of this tumor has been reported, so very little is known about its presentation clinicopathologic patterns and prognosis. We report a patient with primary carcinoid tumor of kidney in a middle-aged woman treated by nephrectomy and review the literature concerning this kind of neoplasm.

How to cite this article:
Geramizadeh B, Khezri A, Shariat M. Renal carcinoid tumor. Saudi J Kidney Dis Transpl 2009;20:462-4

How to cite this URL:
Geramizadeh B, Khezri A, Shariat M. Renal carcinoid tumor. Saudi J Kidney Dis Transpl [serial online] 2009 [cited 2020 Nov 29];20:462-4. Available from: https://www.sjkdt.org/text.asp?2009/20/3/462/50780

   Introduction Top


Renal carcinoid tumors are very rare. Rensick et al reported the first case in 1966. [1] Since then only 50 cases of renal carcinoid have been reported. [2] The largest report is from several centers of US which had reported 21 cases of renal carcinoid during 36 years. [3]

We herein report a 49 year old woman who had a primary carcinoid tumor without any evidence of metastasis or carcinoid syndrome.


   Case Report Top


A 49 year old woman presented with chills, fever and weakness as well as right flank pain. Physical examination was unremarkable, except for mild right flank tenderness. Laboratory work­ up showed normal WBC and platelet and low hemoglobin (7.5 g/dL). ESR was also normal. Biochemical study showed normal BUN and creatinine. Abdominal CT scan showed normal­sized kidney with a hypodense round 25 mm mass in the posterior cortex of the right kidney [Figure 1]. Radical nephrectomy was done with the diagnosis of renal cell carcinoma (RCC). Pathologic study of the nephrectomy specimen showed a well-defined, tan-colored, round and well encapsulated mass in the midpole of kidney measuring 2.5 × 2.5 × 2 cm [Figure 2].

Microscopic examination of the renal mass showed tightly packed trabeculae. Nuclei were oval with finely granulated chromatin [Figure 3]. No necrosis, mitosis or atypical cells were de­tected. Immunohistochemical stains showed po­sitive chromogranin, synaptophysin and NSE [Figure 4]. CD10, CK7, CK20, and RCC markers were negative. A diagnosis of typical carcinoid tumor was made.

The postoperative course was uneventful, and the patient discharged in a good condition. Last examination after three months is unremarkable, with no evidence of recurrence or metastasis.


   Discussion Top


Primary renal carcinoid is an exceedingly rare neoplasm. [1] To date about 50 cases have been reported, of these about 1/3 were found in asso­ciation with horseshoe kidney. [4]

Renal carcinoid tumor arises from pre-existing hyperplasia of neuroendocrine cells found within foci of metaplastic or teratomatous epithelium. Because neuroendocrine cells are not present in normal kidneys, the other probable theory is de­rivation from misplaced neural crest during em­bryogenesis. [5]

Most common symptoms at the time of diagnosis are abdominal or low back pain. [4] A minority of patients have constitutional symptoms and some others are asymptomatic and even detected inci­dentally. [5]

Renal carcinoid tumors occur in relatively younger age group, compared to renal cell carci­noma with equal frequency in male and female. [6] It is indistinguishable from other renal tumors such as RCC pre-operatively, and histopatho­logy only results in the final diagnosis. [1],[6]

The relatively large size of the tumors at the time of diagnosis is reported to correlate well with the incidence of metastasis. [7],[8] Outcome is not related to the presence of metastasis at the time of diag-nosis because some of the patients survived for a long time despite of the presence of metastatic disease. [9],[10]

Complete surgical resection is the primary treat­ment of renal carcinoid and curative for localized disease. [11]

In conclusion, renal carcinoids have a better prognosis compared to other renal neoplasms and nephrectomy is curative in localized disease and recommended even in metastatic disease.

 
   References Top

1.Chung HY, Lau WH, Chu SM, et al. Carcinoid tumor of the kidney in a Chinese woman pre­senting with loin pain. Hong Kong Med J 2007;13:406-8.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Romero FR, Rais-Bahrami S, Permpongkosol S, et al. Primary carcinoid tumors of the kidney. J Urol 2006;176:2359-66.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Hansel E, Epstein JI, Berbescu E, et al. Renal carcinoid tumor: A clinicopathologic study of 21 cases. Am J Surg Pathol 2007;31(10):1539-44.  Back to cited text no. 3    
4.Rodrigeuz-Covarrubias F, Gomez X, Valerio JC. Carcinoid tumor arising in horse shoe kidney. Int Urol Nephrol 2007;39:373-6.  Back to cited text no. 4    
5.Shurtleff BT, Shvarts O, Rajfer J. Carcinoid tumor of the kidney: Case report and review of literature. Rev Urol 2005;7(4):229-33.  Back to cited text no. 5    
6.Kawajiri H, Onada N, Ohira M, et al. Carcinoid tumor of the kidney presenting as a large abdominal mass, report of a case. Surg Today 2004;34:86-9.  Back to cited text no. 6    
7.Lowrance WT, Chang SS, Herrel SD. Primary renal carcinoid tumor managed with laparos­copic partial nephrectomy. Urology 2006;67: 622e19-e20.  Back to cited text no. 7    
8.Sahin A, Demirbas M, Ozen H, et al. Primary carcinoid of the kidney. Scan J Urol Nephrol 1996;30:325-7.  Back to cited text no. 8    
9.McVev RJ, Baneriss SS, Evaden BP, et al. Carcinoid tumor originating in a horse shoe kidney. In Vivo 2002;16:197-9.  Back to cited text no. 9    
10.Raslass WF, Ro JY, Ordonez NG, et al. Primary carcinoid of the kidney. Immunohistochemical and ultarstructural study of five patient. Cancer 1993;72:2660-6.  Back to cited text no. 10    
11.Lane BR, Chery F, Jour G: renal neuroendo­crine tumors: a clinicopathological study. BJU Int 2007;100(5):1030-5.  Back to cited text no. 11    

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Correspondence Address:
Bita Geramizadeh
Department of Pathology, Shiraz University of Medical Sciences, P.O. Box 71345-1864, Shiraz
Iran
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PMID: 19414952

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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]

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    Abstract
    Introduction
    Case Report
    Discussion
    References
    Article Figures
 

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