Key result
Among four patients with rare renal primitive neuroectodermal tumors, three (75%) had inferior vena cava involvement, demonstrating the tumor's high propensity for local invasion.
Why the study?
Renal primitive neuroectodermal tumors are rare and aggressive, and the authors aimed to review diagnosis, management, and their propensity to involve the inferior vena cava.
Case Report (n=4)
No
Renal primitive neuroectodermal tumors are rare, aggressive neoplasms with a high propensity for inferior vena cava involvement, and multimodality treatment including surgery and chemotherapy may offer better survival.
The primitive neuroectodermal tumor (PNET) of the kidney is an extremely rare neoplasm, the diagnosis of which mainly depends upon his-topathology, immunohistochemistry (IHC), and cytogenetics. A handful of cases reported in the literature mention about aggressive features of this neoplasm. The purpose of our study was to review our experience in not only the diagnosis and management of the patients with renal PNET but also to highlight its propensity to involve inferior vena cava (IVC) and also present a rare occurrence of Ewing’s sarcoma (ES)/PNET of the renal pelvis.The clinical, operative, and histopathology records of four patients of renal PNET treated between January 2017 and December 2019 were reviewed and data analyzed concerning the available literature. Out of the four patients treated, two had level III and IV IVC thrombus, and one had dense desmoplastic adhesions with the IVC wall. One of the cases had a rare presentation of ES/PNET of the renal pelvis. All patients were managed surgically, while only one patient received adjuvant chemotherapy and following up with remission for the last 2 years and 4 months. On IHC, cluster of differentiation-99 (CD-99) was positive in all patients, and three were positive for Friend leukemia integration-1. PNET of the kidney is primarily an immunohistopathological diagnosis. This neoplasm has an increased propensity for the local invasion of surrounding structures. A multimodality approach with surgery, chemotherapy, and radiotherapy could offer better outcomes, although the prognosis of these tumors remains poor.
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Hota et al. (2020) conducted a case report in Renal primitive neuroectodermal tumor (PNET) (n=4). Radical nephrectomy with or without adjuvant chemotherapy was evaluated on Inferior vena cava (IVC) involvement and survival. Among four patients with rare renal primitive neuroectodermal tumors, three (75%) had inferior vena cava involvement, demonstrating the tumor's high propensity for local invasion.
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