罕見TFE3重排腎細胞癌: 病例報告及文獻回顧

陳兆宏 吳翊豪 林政鋒 劉冠麟 陳文祥 林承家 陳鴻毅

基隆長庚醫院 外科部 泌尿科

A rare case of TFE3-rearranged renal cell carcinoma: A case report of and Literature Review

Chao-Hung Chen, Yi-Hao Wu, Cheng-Feng Lin, Kuan-Lin Liu , Wen-Hsiang Chen, Cheng-Chia Lin, Hong-Yi Chen

Divisions of Urology, Department of Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan

Introduction:

Translocation and transcription factor E3 (TFE3)-rearranged renal cell carcinoma (rRCC) is a rare subtype of renal cell carcinoma. TFE3-rearranged RCC occurs mainly in children and adolescents, although middle-aged cases are also observed. We present the case of a TFE3-rearranged RCC in a 62-year-old man.

Case presentation:

The 62-year-old man had past history of ureter stone and renal stone and received the operation of ureterorenoscopic stone manipulation for several times. This time, he had suffered from left flank pain with extending to lower abdomen for several days. After a series of examination, abdomen CT scan showed a 2.2 cm slightly hyperdense nodule in right kidney. MRI of abdomen scan was also performed for further survey, where report revealed suspicious of right papillary renal cell carcinoma, cT1aN0M0. Robot-assisted laparoscopic right partial nephrectomy was performed smoothly.

Pathologically, the tumor, which measured 2.2 x 2.1 x 1.8 cm, was seen the tumor limited in the kidney with margin negative finding. The tumor’s appearance showed friable solid mass with focal hemorrhage. Immunohistochemically, the tumor cells are immunoreactive for CD10 and TFE3 and negative finding on CAIX, CK7 and Cathepsin K.

Conclusion:

We present a case with rare morphological features that diagnosed as TFE3 translocated RCC. From the literature, it had stronger invasiveness and poor prognosis compared to ccRCC.