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Vojnosanitetski Pregled Jan 2013Renal onkocytoma is a distinctive benign tumor derived from epithelial cells of the distal renal tubules. These tumors are often clinically asymptomatic, diagnosed...
BACKGROUND
Renal onkocytoma is a distinctive benign tumor derived from epithelial cells of the distal renal tubules. These tumors are often clinically asymptomatic, diagnosed accidentally and difficult to distinguish from renal cell carcinoma.
CASE REPORT
We presented a giant renal onkocytoma in a man aged 64, without any signs or symptoms of the urogenital system disorder. The preoperative diagnosis described the tumor mass of the right kidney, size 16 x 14 cm, and indicated a malignant tumor of kidney. The patient underwent radical nephrectomy. The tumor was encapsulated at the intersection with the characteristic central hyaline scar. Microscopically, it was built of uniform polygonal cells with abundant eosinophilic cytoplasm. Immunohystochemiclly, tumor cells were immunoreactive to CK AE1/AE3 and CD 117, but showed negative immunoreactivity to CK 7, RCC marker and Vimentin.
CONCLUSION
Giant renal oncocytomas are rare tumors with benign clinical course. As a rule, they are discovered by accident. Clinical differentiation from malignant tumors of the kidney is not possible. They are treated surgically, mainly by radical nephrectomy. A definitive diagnosis is made only by histopathological examination of tumors using immunohistochemical marker panels.
Topics: Adenoma, Oxyphilic; Humans; Kidney Neoplasms; Male; Middle Aged
PubMed: 23401933
DOI: 10.2298/vsp1301068s -
Anticancer Research Nov 2018Cystathione β-synthase (CBS) catalyzes the conversion of homocysteine and cysteine to hydrogen sulfide (HS) and cystathione, via the trans-sulfuration pathway. CBS...
BACKGROUND
Cystathione β-synthase (CBS) catalyzes the conversion of homocysteine and cysteine to hydrogen sulfide (HS) and cystathione, via the trans-sulfuration pathway. CBS protein expression levels are increased in several different human malignancies, with increased protein expression correlating with parameters such as tumor stage, anaplasia, metastases, and chemotherapy resistance.
MATERIALS AND METHODS
This study employed tissue microarrays to examine CBS expression in benign thyroid tissue, thyroid oncocytomas, thyroid follicular adenomas, and in follicular, papillary, anaplastic, and medullary thyroid carcinomas.
RESULTS
CBS expression was increased in all thyroid carcinomas types compared to benign thyroid tissue, but not in thyroid follicular adenomas or oncocytomas. A similar pattern was observed for nicotinamide phosphoribosyltransferase (NAMPT) tissue microarray analysis comparing thyroid adenomas and follicular carcinomas.
CONCLUSION
For the first time, we showed that an HS-syntheszing enzyme plays a role in thyroid malignancies. Additionally, our data suggest that CBS and NAMPT immunohistochemistry may be useful in differentiating follicular adenomas from follicular carcinomas.
Topics: Adenocarcinoma, Follicular; Adenoma, Oxyphilic; Carcinoma, Neuroendocrine; Cystathionine beta-Synthase; Cytokines; Humans; Hydrogen Sulfide; Immunohistochemistry; Nicotinamide Phosphoribosyltransferase; Thyroid Cancer, Papillary; Thyroid Carcinoma, Anaplastic; Thyroid Neoplasms; Tissue Array Analysis
PubMed: 30396922
DOI: 10.21873/anticanres.12958 -
Archives of Pathology & Laboratory... Jun 2002
Review
Topics: Adenoma, Oxyphilic; Humans; Kidney; Kidney Failure, Chronic; Kidney Neoplasms; Male; Middle Aged; Neoplasms, Multiple Primary; Tomography, X-Ray Computed
PubMed: 12087966
DOI: 10.5858/2002-126-0648-BROWRF -
Head and Neck Pathology Dec 2019Oncocytic sialolipoma is a very rare tumor of which only three cases have been reported. This entity is considered to be a variant of sialolipoma which harbours... (Review)
Review
Oncocytic sialolipoma is a very rare tumor of which only three cases have been reported. This entity is considered to be a variant of sialolipoma which harbours oncocytic nodules within a well-circumscribed lipomatous mass. We report a parotid mass in 73-year-old female that was difficult to diagnose in imaging and on biopsy. Ultrasonography and MRI demonstrated a mass with features thought to be consistent with lipoma. Twice needle core biopsies were performed. Both were indefinite for diagnosis. The first report favoured a lipoma and the second report suggested the lesion represented oncocytic hyperplasia or an oncocytoma. The microscopic examination of the excised surgical specimen demonstrated typical features of oncocytic sialolipoma, characterized by a predominately lipomatous component, sparse normal-appearing salivary gland tissue and multiple oncocytic nodules. This is the second case of oncocytic sialolipoma reported to occur in the parotid gland.
Topics: Adenoma, Oxyphilic; Aged; Female; Humans; Lipoma; Parotid Neoplasms
PubMed: 30539354
DOI: 10.1007/s12105-018-0993-4 -
Medicina 2018Spindle cell oncocytoma is an infrequent benign non-endocrine sellar neoplasm. Due to its similar morphology to pituitary adenomas, consideration of this differential...
Spindle cell oncocytoma is an infrequent benign non-endocrine sellar neoplasm. Due to its similar morphology to pituitary adenomas, consideration of this differential diagnosis would conduce to a more careful surgical approach in order to avoid intraoperative bleeding and aiming to a complete resection, on which depends long-term outcomes. We present the case of a 60-year-old male who complained about visual abnormalities, with computerized visual field confirmation. On biochemistry, a panhypopituitarism was detected. The brain magnetic resonance images showed a sellar mass. A non-functioning pituitary macroadenoma was presumptively diagnosed and due to the visual impairment, surgical transesphenoidal treatment was indicated. The histological diagnosis was spindle cell oncocytoma. Five months after surgery, the control image demonstrated a lesion that was considered as remnant tumor, hence radiosurgery was performed. During the follow-up, the tumor reduced its size and four years after initial treatment, the sellar resonance imaging showed disappearance of the residual tumor. Communication of new cases of this rare entity will enlarge the existing evidence and will help to determinate the most effective treatment and prognosis.
Topics: Adenoma, Oxyphilic; Follow-Up Studies; Humans; Immunohistochemistry; Magnetic Resonance Imaging; Male; Middle Aged; Pituitary Neoplasms
PubMed: 29360074
DOI: No ID Found -
Head and Neck Pathology Jun 2008Clear cell changes may be observed in virtually any benign or malignant tumor of epithelial, mesenchymal, melanocytic and hematopoietic derivation not be attributed to... (Review)
Review
Clear cell changes may be observed in virtually any benign or malignant tumor of epithelial, mesenchymal, melanocytic and hematopoietic derivation not be attributed to variable etiologies. In general, benign and malignant clear cell neoplasms of the head and neck are rare. They may involve various regions and may be of diverse derivations, with only 1-2% of tumors of the salivary glands, jaws and oral mucosa are primarily or almost exclusively composed of clear cells (Maiorano et al., Semin Diagn Pathol 14:203-212, 1997). This review will selectively discuss the clinicopathological features of salivary gland tumors with clear cell changes, which, at times, may pose a diagnostic challenge and dilemma.
Topics: Adenoma, Oxyphilic; Biomarkers, Tumor; Carcinoma, Acinar Cell; Humans; Immunohistochemistry; Salivary Gland Neoplasms
PubMed: 20614333
DOI: 10.1007/s12105-008-0052-7 -
Modern Pathology : An Official Journal... Mar 2022Low-grade oncocytic tumor (LOT) of the kidney is a recently described entity with poorly understood pathogenesis. Using next-generation sequencing (NGS) and...
Low-grade oncocytic tumor (LOT) of the kidney is a recently described entity with poorly understood pathogenesis. Using next-generation sequencing (NGS) and complementary approaches, we provide insight into its biology. We describe 22 LOT corresponding to 7 patients presenting with a median age of 75 years (range 63-86 years) and male to female ratio 2:5. All 22 tumors demonstrated prototypical microscopic features. Tumors were well-circumscribed and solid. They were composed of sheets of tumor cells in compact nests. Tumor cells had eosinophilic cytoplasm, round to oval nuclei (without nuclear membrane irregularities), focal subtle perinuclear halos, and occasional binucleation. Sharply delineated edematous stromal islands were often observed. Tumor cells were positive for PAX8, negative for CD117, and exhibited diffuse and strong cytokeratin-7 expression. Six patients presented with pT1 tumors. At a median follow-up of 29 months, four patients were alive without recurrence (three patients had died from unrelated causes). All tumors were originally classified as chromophobe renal cell carcinoma, eosinophilic variant (chRCC-eo). While none of the patients presented with known syndromic features, one patient with multiple bilateral LOTs was subsequently found to have a likely pathogenic germline TSC1 mutation. Somatic, likely activating, mutations in MTOR and RHEB were identified in all other evaluable LOTs. As assessed by phospho-S6 and phospho-4E-BP1, mTOR complex 1 (mTORC1) was activated across all cases but to different extent. MTOR mutant LOT exhibited lower levels of mTORC1 activation, possibly related to mTORC1 dimerization and the preservation of a wild-type MTOR copy (retained chromosome 1). Supporting its distinction from related entities, gene expression analyses showed that LOT clustered separately from classic chRCC, chRCC-eo, and RO. In summary, converging mTORC1 pathway mutations, mTORC1 complex activation, and a distinctive gene expression signature along with characteristic phenotypic features support LOT designation as a distinct entity with both syndromic and non-syndromic cases associated with an indolent course.
Topics: Adenoma, Oxyphilic; Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma, Renal Cell; Female; Germ Cells; Humans; Kidney; Kidney Neoplasms; Male; Middle Aged; Mutation; TOR Serine-Threonine Kinases
PubMed: 34538873
DOI: 10.1038/s41379-021-00896-6 -
Medicine Jun 2021A hormone-active metastatic Hürthle cell thyroid carcinoma (HCTC) and Graves disease (GD) present a therapeutic challenge and is rarely reported.
RATIONALE
A hormone-active metastatic Hürthle cell thyroid carcinoma (HCTC) and Graves disease (GD) present a therapeutic challenge and is rarely reported.
PATIENT CONCERNS
We present a 64-year-old male patient, who had dyspnea and left hip pain lasting 4 months. He had clinical signs of hyperthyroidism and a tumor measuring 9 cm in diameter of the left thyroid lobe, metastatic neck lymph node and metastases in the lungs, mediastinum, and bones.
DIAGNOSIS
Laboratory findings confirmed hyperthyroidism and GD. Fine-needle aspiration biopsy and cytological investigation revealed metastases of HCTC in the skull and in the 8th right rib. A CT examination showed a thyroid tumor, metastatic neck lymph node, metastases in the lungs, mediastinum and in the 8th right rib measuring 20 × 5.6 × 4.5 cm, in the left acetabulum measuring 9 × 9 × 3 cm and parietooccipitally in the skull measuring 5 × 4 × 2 cm. Histology after total thyroidectomy and resection of the 8th right rib confirmed metastatic HCTC.
INTERVENTIONS
The region of the left hip had been irradiated with concomitant doxorubicin 20 mg once weekly. When hyperthyroidism was controlled with thiamazole, a total thyroidectomy was performed. Persistent T3 hyperthyroidism, most likely caused by TSH-R-stimulated T3 production in large metastasis in the 8th right rib, was eliminated by rib resection. Thereafter, the patient was treated with 3 radioactive iodine-131 (RAI) therapies (cumulative dose of 515 mCi). Unfortunately, the tumor rapidly progressed after treatment with RAI and progressed 10 months after therapy with sorafenib.
OUTCOMES
Despite treatment, the disease rapidly progressed and patient died due to distant metastases. He survived for 28 months from diagnosis.
LESSONS
Simultaneous hormone-active HCTC and GD is extremely rare and prognosis is dismal. Concomitant external beam radiotherapy and doxorubicin chemotherapy, followed by RAI therapy, prevented the growth of a large metastasis in the left hip in our patient. However, a large metastasis in the 8th right rib presented an unresolved problem. Treatment with rib resection and RAI did not prevent tumor recurrence. External beam radiotherapy and sorafenib treatment failed to prevent tumor growth.
Topics: Adenoma, Oxyphilic; Antineoplastic Combined Chemotherapy Protocols; Biopsy, Fine-Needle; Bone Neoplasms; Chemoradiotherapy, Adjuvant; Fatal Outcome; Graves Disease; Humans; Iodine Radioisotopes; Lung Neoplasms; Lymphatic Metastasis; Male; Mediastinal Neoplasms; Middle Aged; Neoadjuvant Therapy; Thyroid Gland; Thyroid Neoplasms; Thyroidectomy
PubMed: 34160415
DOI: 10.1097/MD.0000000000026384 -
Journal of Clinical Pathology Jun 2007
Topics: Adenoma, Oxyphilic; Aged; Female; Follow-Up Studies; Humans; Kidney Neoplasms; Liver Neoplasms; Tomography, X-Ray Computed
PubMed: 17557872
DOI: 10.1136/jcp.2006.044198 -
Asian Pacific Journal of Cancer... Aug 2021The management of follicular (FN) and Hurthle cell neoplasms (HCN) is often difficult because of the uncertainty of malignancy risk. We aimed to assess characteristics...
INTRODUCTION
The management of follicular (FN) and Hurthle cell neoplasms (HCN) is often difficult because of the uncertainty of malignancy risk. We aimed to assess characteristics of benign and malignant follicular and Hurthle neoplasms based on their shape and size.
MATERIALS AND METHODS
Patients with Follicular adenoma (FA) or carcinoma (FC) and Hurthle Cell adenoma (HCA) or carcinoma (HCC) who had preoperative ultrasonography were included. Demographic data were retrieved. Size and shape of the nodules were measured. Logistic regression analyses and odds ratios were performed.
RESULTS
A total of 115 nodules with 57 carcinomas and 58 adenomas were included. Logistic regression analysis shows that the nodule height and the patient age are predictors of malignancy (p-values = 0.001 and 0.042). A cutoff value of nodule height ≥ 4 cm. produces an odds ratio of 4.5 (p-value = 0.006). An age ≥ 55 year-old demonstrates an odds ratio of 2.4-3.6 (p-value = 0.03). Taller-than-wide shape was not statistically significant (p-value = 0.613).
CONCLUSION
FC and HCC are larger than FA and HCA in size, with a cutoff at 4 cm. Increasing age increases the odds of malignancy with a cutoff at 55 year-old. Taller-than-wide shape is not a predictor of malignancy.
Topics: Adenocarcinoma, Follicular; Adenoma; Adenoma, Oxyphilic; Case-Control Studies; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prognosis; Retrospective Studies; Thyroid Neoplasms; Thyroid Nodule; Thyroidectomy; Ultrasonography
PubMed: 34452575
DOI: 10.31557/APJCP.2021.22.8.2597