Surgical treatment of renal cell carcinoma recurrence at the renal fossa following radical nephrectomy

CONTEXTO: A recorrência local única do carcinoma renal de células claras em seu leito renal após nefrectomia radical é um evento raro. Estima-se que essa situação ocorra em 0,8% a 3,6% do total de procedimentos. Comumente, seu diagnóstico é realizado através de tomografia computadorizada de abdômen ou ultra-som renal usados no acompanhamento desses pacientes. É polêmico qual o melhor tratamento dessa rara condição entre urologistas e oncologistas devido aos poucos relatos em literatura. RELATO DE CASO: Relatamos um caso de recidiva neoplásica única no leito renal após quatro anos e meio da nefrectomia radical por adenocarcinoma de células claras, sem evidência de metástases a distância em outros órgãos. O diagnóstico foi realizado por meio de tomografia abdominal em acompanhamento ambulatorial, observando-se massa retroperitoneal em topografia renal. A massa foi retirada por meio de uma incisão subcostal ampliada, em cirurgia sem intercorrências. O paciente evoluiu bem no pós-operatório. Após um ano e meio do procedimento, foi evidenciada uma metástase no pulmão esquerdo, e seis meses após, outra recorrência metastática na nona costela anterior à direita, mesmo com paciente totalmente assintomático. O tratamento cirúrgico agressivo em recorrência local única é um bom método para controlar essa rara doença. Tomografia computadorizada de abdômen deve ser feita em acompanhamento de carcinoma renal por longos períodos após a nefrectomia radical para o diagnóstico de recorrências tardias e o tratamento deve ser feito como o de uma metástase recorrente única.

Cryoablation vs radiofrequency ablation for the treatment of renal cell carcinoma: a meta-analysis of case series studies

OBJECTIVETo determine the current status of the literature regarding the clinical efficacy and complication rates of cryoablation vs radiofrequency ablation in the treatment of small renal tumours.METHODSA review of the literature was conducted. There was no language restriction. Studies were obtained from the following sources: MEDLINE, EMBASE and LILACS.Inclusion criteria were (i) case series design with more than one case reported, (ii) use of cryoablation or radiofrequency ablation, (iii) patients with renal cell carcinoma and, (iv) outcome reported as clinical efficacy.When available, we also quantified the complication rates from each included study.Proportional meta-analysis was performed on both outcomes with a random-effects model. The 95% confidential intervals were also calculated.RESULTSThirty-one case series (20 cryoablation, 11 radiofrequency ablation) met all inclusion criteria.The pooled proportion of clinical efficacy was 89% in cryoablation therapy from a total of 457 cases. There was a statistically significant heterogeneity between these studies showing the inconsistency of clinical and methodological aspects.The pooled proportion of clinical efficacy was 90% in radiofrequency ablation therapy from a total of 426 cases. There was no statistically significant heterogeneity between these studies.There was no statistically significant difference regarding complications rate between cryoablation and radiofrequency ablation.CONCLUSIONSThis review shows that both ablation therapies have similar efficacy and complication rates.There is urgency for performing clinical trials with long-term data to establish which intervention is most suitable for the treatment of small renal masses.

Cytologic diagnosis of vaginal metastasis from renal cell carcinoma: A case report

BACKGROUND: Metastasis of renal cell carcinoma to the vagina is rare, although it may be the first evidence of the existence of the primary tumor. CASE: A metastatic deposit of renal cell carcinoma in the vagina was diagnosed by cytology as clear cell adenocarcinoma, which was confirmed by biopsy. Radiographic and ultrasound examinations confirmed the renal site of origin, which was corroborated by immunohistochemistry of the biopsy specimen. CONCLUSION: When a cytologic diagnosis of vaginal clear cell adenocarcinoma is made, metastasis of renal cell carcinoma should be considered in the differential diagnosis.

Renal cell carcinoma with cutaneous metastasis in a dog

The present report describes the occurrence of skin metastasis in a dog with primary renal carcinoma. The clinical findings included progressive weight loss, inappetence, palpable abdominal mass and cutaneous nodules. The histopathological examination was carried out after unilateral nephrectomy and was confirmed by immunohistochemistry. The immunohistochemical and histopathological findings characterized this case as renal cell carcinoma with skin metastasis.

Hypertrophic osteopathy associated with renal pelvis transitional cell carcinoma in a dog

A 6-year-old male, Belgian shepherd dog was presented with lethargy, oliguria, hematuria, and reluctance to move. The dog developed hypertrophic osteopathy secondary to renal pelvis transitional cell carcinoma. A nephrectomy was performed and after a year, the dog was completely asymptomatic, and no evidence of metastatic disease was present.

GPC3 reduces cell proliferation in renal carcinoma cell lines

Background: Glypican 3 (GPC3) is a member of the family of glypican heparan sulfate proteoglycans (HSPGs). The GPC3 gene may play a role in controlling cell migration, negatively regulating cell growth and inducing apoptosis. GPC3 is downregulated in several cancers, which can result in uncontrolled cell growth and can also contribute to the malignant phenotype of some tumors. The purpose of this study was to analyze the mechanism of action of the GPC3 gene in clear cell renal cell carcinoma.Methods: Five clear cell renal cell carcinoma cell lines and carcinoma samples were used to analyze GPC3 mRNA expression (qRT-PCR). Then, representative cell lines, one primary renal carcinoma (786-O) and one metastatic renal carcinoma (ACHN), were chosen to carry out functional studies. We constructed a GPC3 expression vector and transfected the renal carcinoma cell lines, 786-O and ACHN. GPC3 overexpression was analyzed using qRT-PCR and immunocytochemistry. We evaluated cell proliferation using MTT and colony formation assays. Flow cytometry was used to evaluate apoptosis and perform cell cycle analyses.Results: We observed that GPC3 is downregulated in clear cell renal cell carcinoma samples and cell lines compared with normal renal samples. GPC3 mRNA expression and protein levels in 786-O and ACHN cell lines increased after transfection with the GPC3 expression construct, and the cell proliferation rate decreased in both cell lines following overexpression of GPC3. Further, apoptosis was not induced in the renal cell carcinoma cell lines overexpressing GPC3, and there was an increase in the cell population during the G1 phase in the cell cycle.Conclusion: We suggest that the GPC3 gene reduces the rate of cell proliferation through cell cycle arrest during the G1 phase in renal cell carcinoma.

Antitumor activity of irradiated riboflavin on human renal carcinoma cell line 786-O

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Tratamento cirúrgico na recidiva retroperitoneal tardia por carcinoma renal de células claras após nefrectomia radical

Late renal cell carcinoma recurrence in the renal fossa is a rare event. This condition occurs in 1 to 2% of radical nephrectomies. We reported a late recurrence at the renal fossa about four and half years after radical nephrectomy due to a renal cell carcinoma (RCC) without metastasis elsewhere. Diagnosis in an outpatient follow-up was made during an abdominal computed tomography and we observed a retroperitoneal mass in the renal fossa. The excision at the recurrence area was made through a subcostal transversal incision without any difficulty. After 6 months from this second procedure, there was no evidence of recurrence. The surgical aggressive treatment for late retroperitoneal RCC recurrence is a good method in this rare situation. Abdominal computed tomography must be done during long periods of follow-up for patients with radical nephrectomy for RCC to search for late retroperitoneal recurrences.

Identificação e caracterização de possiveis marcadores moleculares em carcinoma renal de células claras

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação de candidatos a marcadores moleculares envolvidos no carcinoma renal de células claras

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Análise funcional do gene GPC3 em carcinoma renal de células claras

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Análise da expressão e de mecanismos de regulação de genes envolvidos na transição epitélio mesênquima em carcinoma renal de células claras

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Prognostic significance of beta-2 adrenergic receptor in oral squamous cell carcinoma

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Actinic cheilitis and squamous cell carcinoma of the lip: clinical, histopathological and immunogenetic aspects

Queilite actínica é a principal lesão pré-neoplásica do lábio. O carcinoma espinocelular do lábio é incluído nas estatísticas brasileiras junto com os cânceres de boca e, em conjunto, somam 40% dos cânceres de cabeça e pescoço. Há certo desconhecimento médico e odontológico em geral quanto aos fatores relacionados à carcinogênese e à progressão de tumores de boca. Genes de supressão tumoral e proteínas regulatórias de proliferação celular exercem papel na evolução da queilite actínica para carcinoma espinocelular e no comportamento biológico deste. O conhecimento de marcadores de diagnóstico e prognóstico e sua investigação têm utilidade no acompanhamento de tais pacientes.

Corrective eyeglasses and medial canthal basal cell carcinoma: a case-control study

Background Corrective eyeglasses are frequently worn by adults, particularly at older ages. Their lenses and frames provide ultraviolet protection. Medial canthal basal cell carcinomas are infrequent (38%), and their relation with the use of corrective glasses was not yet investigated. Objectives To assess the prevalence of corrective eyeglasses use in individuals with medial canthal basal cell carcinoma. Methods Case-control study using two controls matched by age, gender, and ethnicity for each case. Cases were patients with medial canthal basal cell carcinoma, and controls were patients with basal cell carcinoma elsewhere on the face. The prevalence of major risk variables was estimated and adjusted by conditional multiple logistic regression. Results Fifty cases and 100 controls were assessed. The mean patient age was 69.7 years, and 54% of the subjects were females. No difference regarding the eyeglasses use or use duration was found between groups. However, when visual defects were separately evaluated, eyeglasses for myopia correction were independently associated with lower risk of medial canthal basal cell carcinoma development (OR = 0.26; P = 0.03), what can be related to long term local photoprotection. Conclusion The use of eyeglasses for myopia correction is associated with lower prevalence of medial cantal basal cell carcinoma. Risk-reducing mechanisms should be elucidated.