Metastatic collecting duct carcinoma of the kidney treated with sunitinib
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CASE REPORT
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Metastatic collecting duct carcinoma of the kidney treated with sunitinib El Mehdi Tazi1*, Ismail Essadi1, Mohamed Fadl Tazi2, Youness Ahellal2, Hind M’rabti1 and Hassan Errihani1
Abstract Collecting duct carcinoma (CDC) of the kidney is a rare and aggressive malignant tumor arising from the distal collecting tubules which has been shown to have a poor response to several kinds of systemic therapy. We present a case of metastatic CDC that responded favorably to a multiple tyrosine kinase inhibitor, sunitinib, achieving a partial response in both lung and skeletal metastases. To our knowledge, this is the first report showing therapeutic activity of sunitinib against CDC. Considering these findings, it would be worthwhile prospectively investigating the role of multiple tyrosine kinase inhibitors, particularly sunitinib, in the management of metastatic CDC. Keywords: Collecting duct carcinoma, Sunitinib, Metastasis
Introduction Collecting duct carcinoma (CDC) of the kidney, also known as Bellini duct carcinoma, is a rare variant of renal cell carcinoma (RCC) arising from the epithelium of the distal collecting ducts; it accounts for 2% of all RCCs [1]. Clinically, CDC is characterized by an extremely aggressive phenotype, accompanying metastatic diseases at presentation in most reported cases; the prognosis ofCDC is therefore poor, with approximately 70% of patients dying of disease progression within 2 years after diagnosis. In fact, several systemic therapies, including cytokine therapy and cytotoxic chemotherapy, have failed to achieve favorable response to metastatic CDC except for very limited cases [2-7]. Sunitinib is an orally available inhibitor of multiple receptor tyrosine kinases, including vascular endothelial growth factor receptor, platelet-derived growth factor receptor, and others, with direct antitumor and antiangiogenic activity. Based on impressive outcomes in several clinical trials, sunitinib has been approved worldwide for treatment of RCC patients with clear cell histology [8]. Furthermore, significant therapeutic activities of sunitinib against non-clear cell RCCs, for example papillary and chromophobe carcinomas, have also been reported in recent studies [8,9]; however, it remains unknown whether sunitinib has a therapeutic impact on CDC of the kidney. * Correspondence: [email protected] 1 Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco Full list of author information is available at the end of the article
Here, we report the first case of a patient with metastatic CDC of the kidney who had a favorable response to sunitinib treatment.
Case report A 47-year-old man with a 14.1 cm left renal mass extending into the renal vein and metastases involving the bilateral lungs and retroperitoneal lymph nodes were referred to our institution.
Figure 1 Hematoxylin and eosin staining of tissue sections from the nephrectomy specimens demonstrating collecting duct carcinoma (× 400).
© 2011 Tazi et al;
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