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Collecting duct carcinoma of the kidney: Clinicopathological and immunoprofile study of the first reported case in KSA

Abdulkader M. Albasri, Akbar S. Hussainy, Mohamed A. Elkablawy, Abdelaziz R Aljohani

Abstract


Aim (Background):
Collecting duct carcinoma (CDC) is a rare variant of renal cell carcinoma (RCC),
which usually presents with an aggressive behaviour. There has been no
reported case of CDC from Kingdom of Saudi Arabia (KSA), in the literature; and
we report this first case of CDC from Almadinah region, KSA.
Materials and methods:
The paraffin embedded tissue blocks were retrieved from the archives of the
pathology department at a tertiary Hospital in Almadinah. Sections were stained
with Epithelial membrane antigen (EMA), CD10, Ki-67, E-Cadherin, p63,
Vimentin, CK7 and Pan Cytokeratin antibodies.
Results:
A 60-year-old male presented with right-flank pain, episodes of painless
hematuria and low-grade fever for one month. Abdominal ultrasonography and
computed tomography (CT) scan revealed enhancing soft tissue density
measuring 4.6 x 6.5 cm in the center of right kidney. The patient underwent right
radical nephrectomy. Gross pathological examination revealed a tumour in
medullary region of the right kidney with invasive growth pattern. Histologically,
the tumour was composed of tubulo-papillary spaces; lined by hobnail cells
exhibiting marked cytological atypia and nuclear pleomorphism.
Immunohistochemically, the tumor cells were strongly positive for EMA, CK-7,
Pan-CK (AE1/AE3), CD10 and E-cadherin. It was focally positive for vimentin
and negative for p63. Despite radical nephrectomy and radiotherapy, CDC
progressed rapidly with multiple metastases, leading to death of the patient within
24 months of diagnosis.
Conclusion:
We report the first CDC case from western KSA. Early diagnosis and better
treatment options may be helpful for improved prognostic outcome in CDC
patients.


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