Paediatric Renal Cell Carcinoma – A Case Report

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Paediatric Renal Cell Carcinoma – A Case Report

Nusrat Bokhari and Anwar-Ul-Haque
Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad.
We report a case of a four-year-old child with a partly cystic mass arising from right kidney with no lymphadenopathy and treated by simple nephrectomy. The histology showed renal cell carcinoma with a predominantly solid growth pattern, clear to eosinophilic cells, focal papillary features and no extension beyond renal capsule or into renal vein. Renal cell carcinoma of childhood is a rare neoplasm constituting 2.6% of renal neoplasms in children and adolescents younger than 15 years.
Paediatric RCC has a variety of morphological patterns: papillary to alveolar to solid and is associated with numerous gene translocations, most resulting in TFE3 gene fusion, which is expressed immunohistochemically by positive nuclear staining for this protein. Certain morphological features have been debatably associated with specific gene translocations. Although immunohistochemistry and cytogenetic analysis could not be done in our case, certain morphological features were observed such as a more solid growth pattern, hyaline bodies and large vegetable-like cells, that have caused us to guardedly hypothesize upon the possibility of ASPL-TFE3 gene fusion in this tumor.

         

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