Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Collecting duct carcinoma or Bellini duct carcinoma is a highly malignant neoplasm that arises from the collecting duct epithelium of the kidney and accounts for approximately 1% of renal neoplasms. Collecting duct carcinoma generally pursues a more aggressive course than conventional renal cell carcinoma. Metastases to regional lymph nodes, bone, adrenal glands, lung, skin and meninges have been reported. During the 1998-2000 period, 161 patients underwent nephrectomy due to renal cell carcinoma at our hospital. The patients’ age ranged from 24 to 90 (mean 59.5) years. There were 50 female and 111 male patients. Collecting duct carcinoma was diagnosed in three (1.9%) male patients aged 79, 66 and 67 (mean age 71.0) years. The patients presented with hematuria associated with fever, weight loss, pain and palpable abdominal mass. On gross examination, the tumors were located in the medulla of the kidney and extended into the cortex and adjacent adipose tissue. Histologically, the tumors showed tubulopapillary, tubular or solid areas. Immunohistochemically, positive staining with cytokeratin, EMA and Ulex Europaeus agglutinin was observed. All patients had regional lymph node metastases, and two of them died within one month from surgery. The third patient was alive and without signs of recurrence six months from presentation.Karcinom sabirnog kanala ili karcinom Bellinijeva kanala je visoko maligna neoplazma koja nastaje iz epitela bubrežnoga sabirnog kanala i čini otprilike 1% bubrežnih neoplazma. Karcinom sabirnoga kanala uglavnom ima agresivniji tijek od konvencionalnog karcinoma bubrežnih stanica. Opisane su metastaze u regionalne limfne čvorove, kosti, nadbubrežne žlijezde, pluća, kožu i meninge. U razdoblju od 1998. do 2000. godine u našoj je bolnici 161 bolesnik podvrgnut nefrektomiji zbog karcinoma bubrežnih stanica. Bolesnici su bili u dobi od 24 do 90 godina (srednja dob 59,5 godina), a bilo je 50 žena i 111 muškaraca. Karcinom sabirnog kanala dijagnosticiran je u trojice (1,9%) muških bolesnika u dobi od 79, 66 i 67 godina (srednja dob 71,0 godina). Bolesnici su došli s hematurijom udruženom s groznicom, gubitkom težine, bolovima i opipljivom masom u trbušnoj šupljini. Makroskopskim pregledom su tumori locirani u bubrežnoj meduli, a protezali su se u koru i obližnje masno tkivo. Histološki su tumori pokazivali tubulopapilarna, tubularna ili kruta područja. Imunohistokemijski je zabilježeno pozitivno bojenje citokeratinom, EMA i Ulex Europaeus aglutininom. Svi su bolesnici imali metastaze regionalnih limfnih čvorova, a dvojica su umrla kroz mjesec dana nakon operacije. Treći je bolesnik bio živ i bez znakova ponovljene bolesti šest mjeseci nakon dolaska u bolnicu
