Kistik Nefromalı Olguların Klinikopatolojik Özellikleri: Olgu Serisi

Abstract

Kistik nefroma böbreğin nadir görülen multikistik benign tümörüdür. Çalışmamızda 2005– 2017 yılları arasında, Kistik Nefroma tanısı almış 20 olgu, retrospektif olarak incelenerek, klinik ve histopatolojik özellikleri ortaya konuldu.  Hasta kayıtlarından elde edilen bilgiler, klinik hikâyeleri, klinik tanısı ve cerrahi materyalin histopatolojik özelliklerine göre not edildi. Olguların 15’ i kadındı. Yaş aralığı 1 - 63 arasındaydı. 12 vakada lomber veya yan ağrısı şikayeti mevcuttu. 14 hastaya radikal, 6 hastaya parsiyel nefrektomi yapıldı. Olguların takiplerinde rekürrens görülmedi. Kistik nefromalar klinik ve radyolojik olarak diğer kistik renal tümörlerle karışabilir, ayırıcı tanıda histopatolojik inceleme gereklidir. 

Keywords

• Kistik nefroma,böbrek,erişkin,pediatrik

Clinicopathologic Features of Cystic Nephroma: Series of Cases

Abstract

Cystic nephroma is a rare multicystic benign tumor of kidney. In our study we evaluated retrospectively the clinical and histopathologic features of 20 patients with cystic nephroma that were diagnosed between 2005-2017. Demographics of patients, clinical history, clinical diagnosis and pathologic characteristics of the specimen were assessed. 15 patients were female. Ages ranged from 1 to 63 years. 12 patients had lomber or flank pain. 14 patients underwent radical and 6 patients underwent partial nephrectomy. There was no recurrence during follow-up. Cystic nephromas mimic other cystic renal neoplasms clinically and radiologically, necessitating histopathological examination for definitive diagnosis.

Keywords

• Cystic nephroma,kidney,adult,pediatric

References

1. Bonsib SM. Cystic nephroma. Mixed epithelial and stromal tumor. In: Eble JN, Sauter G, Epstein JL, Sesterhenn IA, editors.Pathology and genetics of tumors of the urinary system and male genital organs; WHO classification of tumours. Lyon: IARC Press; 2004. p. 76.
2. Han KR, Janzen NK, Mc Whorter VC, et al. Cystic renal cell carcinoma: biology andClinical behaviour. Urol Oncol 2004;22:410-4.
3. Dell'Atti L. An Unusual Presentation of Cystic Nephroma in an Adult Man. . Rare Tumors. 2015 May 18;7(2):5860. doi: 10.4081/rt.2015.5860. eCollection 2015 May 5.
4. Mohanty D, Jain BK, Agrawal V, Gupta A. Cystic nephroma:A diagnostic dilemma. Saudi J Kidney DisTranspl. 2010 May;21(3):518–20.
5. Van Den Hoek J, De Krijger R, Van De Ven K, Lequin M,Van Den Heuvel-Eibrink MM. Cystic nephroma, cystic partially differentiated nephroblastoma and cystic Wilms’ tumor in children: A spectrum with therapeutic dilemmas. Urol Int. 2009 Jan;82(1):65–70. http://dx.doi.org/10.1159/000176028
6. Zhou M, Kort E, Hoekstra P, Westphal M, Magi-Galluzzi C,Sercia L, et al. Adult cystic nephroma and mixed epithelial and stromal tumor of the kidney are the same disease entity: Molecular and histologic evidence. Am J SurgPathol. 2009 Jan;33(1):72–80. http://dx.doi.org/10.1097/PAS.0b013e3181852105
7. Wilkinson C, Palit V, Bardapure M, Thomas J, Browning AJ, Gill K, Biyani CS. Adult multilocular cystic nephroma: Report of six cases with clinical, radio-pathologic correlation and review of literature. Urol Ann. 2013 Jan;5(1):13-7. doi: 10.4103/0974-7796.106958.
8. Kuzgunbay B, Turunc T, Bolat F, Kilinc F.Adult cystic nephroma: a case report and areview of the literature. Urol Oncol2009;27:407-9.

9. Falidas E, Ntasi A, Mathioulakis S, et al.Multicystic nephroma in an elderly man.Case report. G Chir 2011; 32:483-6.
10. Eble J. Cystic partially differentiated nephroblastoma. In: Eble JN,Sauter G, Epstein JI, Sesterhenn IA, eds. World Health Organization Classification of Tumours Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. Lyon: IARC Press; 2004:55.
11. Bonsib SM. Cystic nephroma. In: Eble JN, Sauter G, Epstein JI,Sesterhenn IA, eds. World Health Organization Classification of Tumours Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. Lyon: IARC Press; 2004:76.
12. Michal M, Amin MB, Delahunt B, et al. Mixed epithelial stromal tumor family. In: Moch H, Humphrey PA, Ulbright TM, ReuterVE,eds. World Health Organization Classification of Tumors: Pathology and Genetics of Tumors of the Urinary System and Male Genital Organs, 4th ed. Lyon: IARC Press; 2016:70–71.
13. Argani P, Bruder E, Dehner L, et al. Paediatric cystic nephroma. In: Moch H, Humphrey PA, Ulbright TM, ReuterVE,eds. World Health Organization Classification of Tumors: Pathology and Genetics of Tumors of the Urinary System and Male Genital Organs,4th ed. Lyon: IARC Press; 2016:53.
14. Li Y, Pawel BR, Hill DA, Epstein JI, Argani P. Pediatric Cystic Nephroma Is Morphologically, Immunohistochemically, and Genetically Distinct From Adult Cystic Nephroma. Am J Surg Pathol. 2017 Apr;41(4):472-481. doi: 10.1097/PAS.0000000000000816.
15. Bouhafs A, Cherradi N, Lamaalmi N, Beklachem R, Barahioui M. An unusualcase of multicystic Nephroma with prominent renal pelvis involvement. Int J Urol 2006;13:436-8.
16. Zdrojowy R, Sawicz-Birkowska K,Apoznański W, et al. Adult Wilms tumour. Int Urol Nephrol 2011;43:691-6.
17. Bisceglia M, Galliani CA, Senger C, et al.Renal cystic diseases: a review. AdvAnatom Pathol 2006;13:26-56.
18. Chu LC, Hruban RH, Horton KM, Fishman EK. Mixed epithelial and stromal tumor ofThe kidney: radiologic-pathologic correlation. Radiographics 2010;30:1541-51.
19. Silver IM, Boag AH, Soboleski DA. Best cases from the AFIP: multilocular cysticRenal tumor: cystic nephroma.
20. Grosse C, Sonnberger U, Grosse A, Breinl E, HerganK. Multilocular cystic nephroma: Atypical sonographic and computed tomographic findings. Eur J RadiolExtra. 2006 Apr;58(1):13–16. http://dx.doi.org/10.1016/j.ejrex.2006.01.007
21. Boybeyi O, Karnak I, Orhan D et al (2008) Cystic nephroma and localized renal cystic disease in children: diagnostic clues and management. J Pediatr Surg 43:1985–1989
22. Powell T, Shackman R, Johnson HD. Multilocular cysts of the kidney. Br J Urol. 1951 Jun;23(2):142–52. http://dx.doi.org/10.1111/j.1464-410X.1951.tb02576.x
23. Joshi VV, Beckwith JB. Multilocular cyst of the kidney (cystic nephroma) and cystic, partially differentiated nephroblastoma. Terminology and criteria for diagnosis. Cancer. 1989 Jul;64(2):466–79. http://dx.doi.org/10.1002/1097-0142(19890715)64:2%3C466::AID-CNCR2820640221%3E3.0.CO;2-V
24. Agrons GA, Wagner BJ, Davidson AJ, Suarez ES. Multilocular cystic renal tumor in children: Radiologic-pathologic correlation. Radio Graphics. 1995 May;15(3):653–69. http://dx.doi.org/10.1148/radiographics.15.3.7624570
25. Mukhopadhyay S, Valente AL, de la Roza G. Cystic Nephroma: A histologic and immunohistochemical study of 10 cases. Arch Path Lab Med 2004;128:1404-11.
26. Dong B, Wang Y, Zhang J, et al. Multilocular cystic nephroma treated withLaparoscopic nephron-sparing surgery: a case report. Can Urol Assoc J 2014;8:e545- 7.
27. Bastian PJ, Kulhmann R, Vogel J, Bastian HP. Local recurrence of an unilateral cystic nephroma. Int J Urol 2004;11:329-31.
28. Castillo OA, Boyle ET Jr, Kramer SA. Multilocular cysts of kidney. A studyof 29 patients and review of literature. Urology 1991;37:156-62.