Ipsilateral Synchronous Papillary and Clear Cell Renal Cell Carcinoma: a Case Report and Literature Review

Abstract Background: The rare disease of ipsilateral synchronous papillary and clear cell renal cell carcinoma was often misdiagnosed as a single tumor with intra-renal metastasis or some other diseases preoperatively. Both of the effective management and long overall survival might be affected as the different prognosis of the two kinds of tumors. Here, we report a case of ipsilateral synchronous papillary and clear cell renal cell carcinoma, and present the clinicopathological features as well as review the literature in China.Case presentation: A 70-year-old man presented with a single mass in the left renal revealed either by ultrasound or CT during a routine physical examination. The tumor was occurred as two isolated masses in the gross finding. Hematoxylin and eosin staining and immunohistochemistry were performed. Papillary cell carcinoma and clear cell renal cell carcinoma were the compositions of the tumors. Immunostainings were as follows: The papillary renal cell carcinoma showed positive for CK7, P504s, Pax8,Vimentin, and scatterly for CD10, the proliferation rates of Ki67 was just 3%; While the clear cell renal cell carcinoma was positive for Pax8,CAIX,Vimentin, and diffusely for CD10, but negative for CK7 and P504s, the Ki67 proliferation rates was 5%. The patient was diagnosed with ipsilateral synchronous papillary and clear cell renal cell carcinoma, and free from the disease 9 months after surgery.Conclusions: Ipsilateral synchronous papillary and clear cell renal cell carcinoma is a rare condition without specific clinical manifestations. The understanding of the computed tomography features and increasing the awareness or experience of the disease may be helpful to improve the preoperative diagnosis accuracy. Precise diagnosis should be based on histopathological morphology and immunostaining. As the different prognosis of the two tumors, optimal surgical treatment should be performed to prolong the survival time.