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Perioperative images. a CT showing bilateral nephrolithiasis (three minor stones in the right kidney and a staghorn stone in the left), light hydronephrosis of the right kidney and left pyonephrosis. b CT showing severe hydronephrosis of the left kidney and ambiguous soft tissues. o = Soft tissues which might be malignant. c Nuclide bone scan showing bone metastasis of thoracic vertebra, iliac bone and femoral bone. d CT showing tumor recurrence in retroperitoneum.
Source publication
Primary adenocarcinoma of the renal pelvis is rarely reported in the literature. Here we present a case of primary mucinous adenocarcinoma of the renal pelvis with elevated serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels. A 56-year-old woman was referred to our center with intermittent fever and left-sided back pa...
Contexts in source publication
Context 1
... ex- amination was unremarkable and the serum creatinine level was 91 mol/l (normal 50-110 mol/l). Computed tomography (CT) showed bilateral nephrolithiasis, mild right hydronephrosis and left pyonephrosis with ambiguous soft tissues ( fig. 1 a). A radionu- cleorenogram showed that the glomerular filtration rate (GFR) of the left and right kidney was 0 and 79 ml/min, respectively. ...
Context 2
... a subsequent visit 2 months later for iliac pain, ten- derness of the bilateral iliac and lower thoracic vertebrae was detected by physical examination. A nuclide bone scan ( fig. 1 c) demonstrated multiple bone metastases, and CT scan ( fig. 1 d) found recurrence in the left renal fossa. The serum levels of CEA, CA19-9 and CA125 were 151.83, 92.97 and 11.7 g/l. ...
Context 3
... a subsequent visit 2 months later for iliac pain, ten- derness of the bilateral iliac and lower thoracic vertebrae was detected by physical examination. A nuclide bone scan ( fig. 1 c) demonstrated multiple bone metastases, and CT scan ( fig. 1 d) found recurrence in the left renal fossa. The serum levels of CEA, CA19-9 and CA125 were 151.83, 92.97 and 11.7 g/l. ...
Context 4
... a cor- rect diagnosis was not made before the operation with CT scans, and the mucin of the tumor was mistaken as pyo- nephrosis. Reviewing the CT, some potential image char- acteristics ( fig. 1 b) might reveal the presence of renal pel- vis neoplasms. It is therefore very important to pay close attention to cases of pyonephrosis with a long history of chronic irritations. ...
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Purpose:
A growing body of evidence suggest it is safe to ligate the ureter of poorly functioning renal moieties during renal transplantation. Herein, we present clinical outcomes and data on hydronephrosis progression in pediatric cases associated with ectopic ureters and obstructive ureteroceles.
Material and methods:
Prospective data collecti...
Citations
... The CEA assay has been used to determine the tumor progression stage, monitor the treatment efficacy, and identify the post-surgery recurrence with a sensitivity of approximately 80% and a specificity of around 70% [104]. Though CEA is canonically used for colorectal cancer diagnosis, its expression is also elevated in other cancers such as stomach [105], pancreas [106], lung [107], breast [108], and renal malignancies [109]. ...
Cancer is still one of the most arduous challenges in the human society, even though humans have found many ways to try to conquer it. With our incremental understandings on the impact of sugar on human health, the clinical relevance of glycosylation has attracted our attention. The fact that altered glycosylation profiles reflect and define different health statuses provide novel opportunities for cancer diagnosis and therapeutics. By reviewing the mechanisms and critical enzymes involved in protein, lipid and glycosylation, as well as current use of glycosylation for cancer diagnosis and therapeutics, we identify the pivotal connection between glycosylation and cellular redox status and, correspondingly, propose the use of redox modulatory tools such as cold atmospheric plasma (CAP) in cancer control via glycosylation editing. This paper interrogates the clinical relevance of glycosylation on cancer and has the promise to provide new ideas for laboratory practice of cold atmospheric plasma (CAP) and precision oncology therapy.
... Serum CEA was 25.43 ng/mL and serum CA 19-9 was 69.29 U/mL before surgery, which decreased to 2.67 ng/mL and 30.63 U/mL, respectively, 1 wk after the operation. According to the literature, CEA and CA 19-9 levels also increase in patients with renal pelvis mucinous tumors [13]. Therefore, for patients without related primary tumors, the levels of CEA and CA 19-9 have certain reference significance for preoperative diagnosis and can be used as reference indices during postoperative follow-up. ...
Background:
Villous adenoma is a rare tumor in the urinary system that usually occurs in the bladder. It is extremely uncommon in the renal pelvis. Most of the previously reported cases have been diagnosed with severe hydronephrosis associated with renal parenchyma atrophy prior to surgery. Because of its rarity, available information on the pathogenesis, diagnosis, treatment and prognosis of the disease is limited. We reported a case of kidney stones with hydronephrosis. During percutaneous nephroscopic lithotripsy, a renal pelvis tumor was found. Biopsy confirmed that the tumor was a villous adenoma of the renal pelvis.
Case summary:
A 68-year-old female was admitted to the hospital due to right kidney stones with right hydronephrosis. After admission, a urinary system plain computed tomography scan was performed, which revealed right kidney stones with right hydronephrosis and right upper ureteral dilatation. Multiple new cauliflower-like papillary masses were then discovered in the renal pelvis and calyces during right percutaneous nephroscopic lithotripsy. Biopsy results indicated villous adenoma with high-grade glandular intraepithelial neoplasia. The patient underwent laparoscopic radical resection of the right kidney and ureter. Based on histopathological and immunohistochemical examination, the patient was diagnosed with villous adenoma without adenocarcinoma.
Conclusion:
Villous adenoma is rare in the urinary system. We reported a case of renal pelvis villous adenoma, which may provide useful information for the early diagnosis and treatment of this tumor.
... CEA is also expressed in diverse carcinomas including breast [142], gastric [143], pancreatic [144], renal [145], and lung [146]. In colon carcinogenesis, CEA overexpression contributes to disturb the normal histological architecture of colonic epithelium [147] and facilitates cellular migration and metastization [148]. ...
Cancer serum biomarkers are valuable or even indispensable for cancer diagnostics and/or monitoring and, currently, many cancer serum markers are routinely used in the clinic. Most of those markers are glycoproteins, carrying cancer-specific glycan structures that can provide extra-information for cancer monitoring. Nonetheless, in the majority of cases, this differential feature is not exploited and the corresponding analytical assays detect only the protein amount, disregarding the analysis of the aberrant glycoform. Two exceptions to this trend are the biomarkers α-fetoprotein (AFP) and cancer antigen 19-9 (CA19-9), which are clinically monitored for their cancer-related glycan changes, and only the AFP assay includes quantification of both the protein amount and the altered glycoform. This narrative review demonstrates, through several examples, the advantages of the combined quantification of protein cancer biomarkers and the respective glycoform analysis, which enable to yield the maximum information and overcome the weaknesses of each individual analysis. This strategy allows to achieve higher sensitivity and specificity in the detection of cancer, enhancing the diagnostic power of biomarker-based cancer detection tests.
... Patients with primary renal pelvis MAC generally have a poor prognosis, with a survival rate of 2-5 years within the follow-up period (30,31). Similar to transitional cell carcinoma, this primary MAC is managed by radical nephroureterectomy with a bladder cuff (4,5,28). ...
Background
Mucinous neoplasms are tumors arising in the epithelial tissue, characterized by excessive mucin secretion. They mainly emerge in the digestive system and rarely in the urinary system. They also seldom develop in the renal pelvis and the appendix asynchronously or simultaneously. The concurrence of this disease in these two regions has not yet been reported. In this case report, we discuss the diagnosis and treatment of synchronous mucinous neoplasms of the right renal pelvis and the appendix. The mucinous neoplasm of the renal pelvis was preoperatively misdiagnosed as pyonephrosis caused by renal stones, and the patient underwent laparoscopic nephrectomy. Herein, we summarize our experience with this rare case in combination with related literature.
Case presentation
In this case, A 64‐year‐old female was admitted to our hospital with persistent pain in the right lower back for over a year. Computer tomography urography (CTU) showed that the patient was confirmed as right kidney stone with large hydronephrosis or pyonephrosis, and appendiceal mucinous neoplasm (AMN). Subsequently, the patient was transferred to the gastrointestinal surgery department. Simultaneously, electronic colonoscopy with biopsy suggested AMN. Open appendectomy plus abdominal exploration was performed after obtaining informed consent. Postoperative pathology indicated low-grade AMN (LAMN) and the incisal margin of the appendix was negative. The patient was re‐admitted to the urology department, and underwent laparoscopic right nephrectomy because she was misdiagnosed with calculi and pyonephrosis of the right kidney according to the indistinctive clinical symptoms, standard examination of the gelatinous material, and imaging findings. Postoperative pathology suggested a high‐grade mucinous neoplasm of the renal pelvis and mucin residing partly in the interstitium of the cyst walls. Good follow-up results were obtained for 14 months.
Conclusion
Synchronous mucinous neoplasms of the renal pelvis and the appendix are indeed uncommon and have not yet been reported. Primary renal mucinous adenocarcinoma is very rare, metastasis from other organs should be first considered, especially in patients with long-term chronic inflammation, hydronephrosis, pyonephrosis, and renal stones, otherwise, misdiagnosis and treatment delay may occur. Hence, for patients with rare diseases, strict adherence to treatment principles and close follow‐up are necessary to achieve favorable outcomes.
... Although tumor markers are not routinely used as a screening tool for identifying renal malignancy, they may be a useful complement to detect the presence of mucinous adenocarcinoma. Abnormalities in CEA or CA19-9 have been reported in mucinous adenocarcinoma of the renal pelvis, but this accounts for only approximately 20% of patients (7,18). A slight elevation of CA19-9 was found in a case of prostate mucinous adenocarcinoma (19). ...
Mucinous adenocarcinoma of the kidney is rarely reported in the literature. We present a previously unreported mucinous adenocarcinoma arising from the renal parenchyma. A 55-year-old male patient with no complaints showed a large cystic hypodense lesion in the upper left kidney on contrast-enhanced computed tomography (CT) scan. A left renal cyst was initially considered, and a partial nephrectomy (PN) was performed. During the operation, a large amount of jelly-like mucus and bean-curd-like necrotic tissue was found in the focus. The pathological diagnosis was mucinous adenocarcinoma, and further systemic examination revealed no clinical evidence of primary disease elsewhere. Then the patient underwent left radical nephrectomy (RN), and the cystic lesion was found in the renal parenchyma, while neither the collecting system nor the ureters were involved. Postoperative sequential chemotherapy and radiotherapy were administered, and no signs of disease recurrence were observed over 30 months of follow-up. Based on a literature review, we summarize the lesion with rarity and the associated dilemma in preoperative diagnosis and treatment. Given the high degree of malignancy, a careful history analysis accompanied by dynamic observation of imaging and tumor markers is recommended for the diagnosis of the disease. Comprehensive treatment based on surgery may improve its clinical outcomes.
... Although some scholars found that the serum CEA and CA19-9 levels in patients with this disease increased, which may provide a reference for the diagnosis of this disease. [6] But the diagnosis of most patients mainly depends on the pathological diagnosis after the operation. For patients with MARP, it is difficult to make a clear diagnosis before the operation. ...
Rationale:
Mucinous adenocarcinoma of the renal pelvis is extremely rare in malignancy of the renal pelvis, and <100 cases have been reported so far. However, horseshoe kidneys appear to be more prone to this mucinous gland metaplasia. Due to the lack of a specific diagnostic basis, it is difficult to confirm the diagnosis before surgery, which is easy to cause misdiagnosis.
Patient concerns:
We report a 64-year-old male patient who found a cystic mass in the left kidney during physical examination. CT examination showed a horseshoe kidney with a cystic mass 9.5 × 8.0 cm in front of the left kidney, lacking obvious diagnostic features.
Diagnosis:
It was misdiagnosed as cystic teratoma before the operation, and was diagnosed as mucinous adenocarcinoma of the renal pelvis through pathological examination after the operation.
Interventions:
Resection of the tumor by nephron-sparing surgery and postoperative chemotherapy.
Outcomes:
No tumor recurrence was found at 6 years of follow-up. After 7 years, the patient had multiple metastases in the abdominal wall and peritoneum, and no tumor recurrence was found in the urinary system. The patient received chemotherapy again and survived well.
Lessons:
The prognosis of nephron-sparing tumor resection for MRAP is not significantly different from that of radical nephroureterectomy + bladder cuff excision. Because it can reduce the risk that patients can not tolerate follow-up chemotherapy due to abnormal renal function after surgery, which may be more beneficial in patients with kidney abnormalities or chronic disease.
... The prognosis of primary adenocarcinoma of the renal pelvis is generally poor, with most patients dying during the 2-5 year follow-up period. The longest reported follow-up period with good prognosis was 79 months (22). Chemotherapy, radiotherapy, and chemoradiotherapy has FIGURE 4 Timeline of the historical and current information from this episode of care. ...
Background:
Mucinous cystadenocarcinoma (MC) of the kidney is a rare renal epithelial tumor originating from the renal pelvic urothelium. There are only a few published reports on MC. Due to its rare and unknown tissue origin, its diagnosis is difficult which almost can be diagnosed through the pathological method.
Case presentation:
In this case report, we report a female patient whose chief complaint was low back pain lasting for one month. The three-dimensional computed tomography scan of the urinary system detected approximately 7 cm of a left renal cystic mass. The renal cystic mass was diagnosed as MC after robot-assisted laparoscopic radical nephrectomy. The MC originated from the kidney after completing colorectal adenocarcinoma and ovarian adenocarcinoma.
Conclusions:
We reported a case of MC of the kidney which was a rare renal tumor. We not only aimed to present an unusual case of MC and review the previous literature on its pathology and differential diagnosis, but also used new method to treat this type of tumor.
... The longest reported follow-up period with good prognosis was 79 months. [21]. Chemotherapy, radiotherapy, and chemoradiotherapy has been recommended for the treatment of mucinous colorectal cancer and mucinous ovarian carcinoma [4]. ...
Background: Mucinous cystadenocarcinoma (MC) of the kidney is a rare renal epithelial tumor originating from the renal pelvic urothelium. There are only a few published reports on MC. Due to its rare and unknown tissue origin, its diagnosis is difficult which almost can be diagnosed through the pathological method.
Case presentation: In this case report, we report a female patient whose chief complaint was low back pain lasting for one month. The three-dimensional computed tomography scan of the urinary system detected approximately 7 cm of a left renal cystic mass. The renal cystic mass was diagnosed as MC after robot-assisted laparoscopic radical nephrectomy. The MC originated from the kidney after completing colorectal adenocarcinoma and ovarian adenocarcinoma.
Conclusions: We reported a case of MC of the kidney which was a rare renal tumor. We not only aimed to present an unusual case of MC and review the previous literature on its pathology and differential diagnosis, but also used new method to treat this type of tumor.
... The longest reported follow-up period with good prognosis was 79 months. [21]. Chemotherapy, radiotherapy, and chemoradiotherapy has been recommended for the treatment of mucinous colorectal cancer and mucinous ovarian carcinoma [4]. ...
Background: Mucinous cystadenocarcinoma (MC) of the kidney is a rare renal epithelial tumor originating from the renal pelvic urothelium. There are only a few published reports on MC. Due to its rare and unknown tissue origin, its diagnosis is difficult which almost can be diagnosed through the pathological method.
Case presentation: In this case report, we report a female patient whose chief complaint was low back pain lasting for one month. The three-dimensional computed tomography scan of the urinary system detected approximately 7 cm of a left renal cystic mass. The renal cystic mass was diagnosed as MC after robot-assisted laparoscopic radical nephrectomy. The MC originated from the kidney after completing colorectal adenocarcinoma and ovarian adenocarcinoma.
Conclusions: We reported a case of MC of the kidney which was a rare renal tumor. We not only aimed to present an unusual case of MC and review the previous literature on its pathology and differential diagnosis, but also used new method to treat this type of tumor.
... is an important tumor marker and has been found to be elevated in a variety of malignant tumors (24)(25)(26)(27). The expression of CEA also increases in patients with lung cancer, especially those with LUAD, and has higher diagnostic value than do the other types (28)(29)(30). ...
... First discovered by Gold and Freedman in 1965 (40), CEA is an acid glycoprotein with human embryonic antigen specificity present in the human digestive system and embryonic tissues. CEA has been studied in gastric cancer (24), pancreatic cancer (25), renal pelvis adenocarcinoma (26), and breast cancer (27), and its high expression (positivity) has been significantly associated with worse prognosis. However, for the prediction of NSCLC, preoperative CEA level is controversial. ...
Background:
Patients with stage I lung adenocarcinoma (LUAD) have varying postoperative prognosis. This study aimed to investigate the prognostic significance of postoperative longitudinal change of serum carcinoembryonic antigen (CEA) level in patients with stage I LUAD.
Methods:
The study cohort comprised 241 patients with stage I LUAD completely resected with single-port video-assisted thoracic surgery (VATS). The patients were categorized into 4 groups according to the postoperative longitudinal change of serum CEA levels measured in the third and sixth months after surgery: the NN group (continuously normal), HN group (increase first and then decrease), NH group (decrease first and then increase), and HH group (continuously high). Recurrence-free survival (RFS) was analyzed by the Kaplan-Meier method and compared by log-rank test. A nomogram was developed to predict recurrence in the stage I LUAD patients.
Results:
In univariate analysis, differentiation (P<0.001), visceral pleural invasion (VPI) (P=0.025), tumor diameter (P<0.001), tumor-node-metastasis (TNM) stage (P=0.008), preoperative CEA levels (≥10.0 vs. <10.0 ng/mL, P<0.001), and postoperative CEA grouping (NH/HH vs. NN/HN, P<0.001) were significant prognostic factors for stage I LUAD patients. Multivariate analysis showed that tumor diameter (P=0.009) and postoperative CEA grouping (P<0.001) were considered to be independent prognostic factors of postoperative recurrence of stage I LUAD. Tumor diameter (≥20 mm) and postoperative CEA (NH/HH vs. NN/HN) were associated with worse RFS. Receiver operating characteristic (ROC) curve analysis showed that postoperative CEA (NH/HH vs. NN/HN) have high sensitivity (64.7%) and specificity (83.2%) for early prediction of postoperative recurrence of stage I LUAD. The area under curve (AUC) value was 0.745. The nomogram based on multivariate Cox regression had a concordance index (value of 0.789). The calibration plot showed that the predicted probabilities closely matched the observed probabilities.
Conclusions:
Longitudinal change in serum CEA level after surgery was found to be an independent unfavorable prognostic factor in completely resected stage I LUAD patients. The NH group and HH group were significantly associated with worse RFS. A nomogram was established to predict the postoperative recurrence of patients with stage I LUAD.
