Câncer de Rim
Patologia
Best papers
2011/2012
Paulo Guilherme de Oliveira Salles
Agenda
• Necrose e Ca renal
• Urologista e o paciente com Ca renal: um
casamento eterno
• MiTF/TFE Family Translocation Renal
Tumors
Necrose
• Histologic tumor necrosis is an independent
prognostic indicator for clear cell and
papillary renal cell carcinoma. Am J Clin
Pathol. 2012 Feb;137(2):283-9.
• Is the presence or absence of tumour
necrosis a significant predictor of survival in
renal cell cancer? Urol Int. 2012;88(1):79-83.
• Necrosis assessment in renal carcinoma. Hum
Pathol. 2012 Jan;43(1):150-1
Laudo AP
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Tipo histológico
Tamanho do tumor
Grau nuclear de Fuhrman
Transformação sarcomatóide e necrose
Invasão vascular peritumoral e da veia renal
Extensão para v. cava inferior
TNM
Margens cirúrgicas (artéria renal, veia renal, ureter
e fáscia de Gerota)
Urologista e o paciente
com Ca renal: um
casamento eterno
• Renal cell carcinoma metastatic to the nasal
cavity. Int J Clin Exp Pathol 2012;5(6):588-91.
• A case of bladder metastasis of renal cell
carcinoma: a case report and literature
review. Hinvokika Kiyo. 2012 May;58(5):231-5.
Urologista e o paciente
com Ca renal: um
casamento eterno
• Brain metastasis in a patient with a
sarcomatoid variant RCC with well-controlled
extracerebral metastases by temsirolimus.
Anticancer Res. 2012 Aug;32(8):3443-7.
• Thyroid-like metastases to the scalp from a
papillary renal cell carcinoma: a case report.
Tumori. 2012 May-Jun;98(3):79e-81e.
Urologista e o paciente
com Ca renal: um
casamento eterno
• Metastatic renal cell carcinoma presenting as
gastric polyps: A case report and review of
the literature. Int J Surg Case Rep. 2012;
3(12): 601–604.
• Solitary gastric metastasis from a renal cell
carcinoma, presenting 23 years after radical
nephrectomy. Endoscopy. 2012 May;44 Sup 2.
MiTF/TFE
MiTF/TFE
Pedram Argani,* Cristina R. Antonescu,‡‡
Peter B. Illei,‡‡ Man Yee Lui,‡‡
Charles F. Timmons,† Robert Newbury,‡
Victor E. Reuter,‡‡ A. Julian Garvin,§
Antonio R. Perez-Atayde,¶i Jonathan A.
Fletcher,¶i
J. Bruce Beckwith,** Julia A. Bridge,†† and
Marc Ladanyi‡‡
MiTF/TFE
• can encode proteins that would act as mediators
related to cell growth and motility, potential for
invasion and cellular morphogenetic
differentiation.
• recognizing and studying such chromosomal
change could have a fundamental role for
understanding carcinogenesis, as well as for
diagnosing and determining prognostic factors
associated with kidney carcinomas.
MiTF/TFE
•TFE3: renal cell carcinoma, alveolar soft part
sarcoma, melanotic renal cell cancer, melanotic
neoplasm of the ovary
•TFEB: renal cell carcinoma
•MiTF: melanoma,
angiomyolipoma
•TFEC: unknown
clear
cell
sarcoma,
renal
MiTF/TFE
• first report of translocation in renal tumors: Cohen et al
– 1979 (hereditary renal cell carcinoma associated with a
chromosomal translocation)
• usually tumors in children and young adults (17-monthold to 78-year-old)
• TFE3: de Jong et al – 1986 (2.4-y-old boy)
• TFEB: Argani et al – 2001 (07 cases, 4M:3F, 9-33-y-old)
MiTF/TFE
• translocation RCCs occur primarily, but not
exclusively, in children and young adults and are
believed to be rather indolent even when
diagnosed at advanced stages.
• there have been increasing, recent reports of
translocation RCC with aggressive clinical course in
patients aged 16 and older.
MiTF/TFE
• translocation RCCs may be inherently more
aggressive in adults than in children; however, the
relatively short follow-up periods currently
available and the potential bias inherent in
nonconsecutive case series and case reports
preclude a definitive statement.
• the current management for localized tumors is
quite similar to conventional RCCs.