To the content
4 . 2022

Bellini ductal carcinoma: literature review and case report

Abstract

Bellini ductal carcinoma (BDC) of the kidney develops from the collecting ducts and is characterized by an aggressive course and an extremely unfavorable prognosis. Currently, this tumor accounts for 0.4% to 2.0% of all renal cell carcinomas. More than 2/3 of patients with PCB present with locoregional or systemic symptoms on admission. Most often, metastases are detected in the regional lymph nodes (especially in the para-aortic, paracaval and cervical), lungs, liver, adrenal glands, and bones. The rarity of this cancer makes it extremely difficult to explore the prospects for its treatment on a large scale. To date, there is no standard protocol for BDC treatment. The only potentially definitive treatment is surgery, if performed on patients with localized tumors, even in the presence of solitary metastases. Due to the resistance of renal carcinoma to radiation, systemic chemotherapy, immunochemotherapy, these methods are indicated only as palliative care. The article presents the clinical diagnostic criteria, data of radiology methods, morphological signs, differential diagnostic series and principles of treatment at the moment.

The rarity of this morphological form of kidney tumors, as well as the absence of related publications in the Russian-language literature, makes it relevant to present our own clinical case.

Man S., 58 years old, complained of periodic pulling pains in the right lumbar region, evening fever up to 38 °C. With the above complaints, the patient turned to the urologist at the place of residence. MSCT of the abdominal cavity and small pelvis revealed cancer of the right kidney with a tumor thrombus in the inferior vena cava. The head of the tumor thrombus according to MSCT at the level of the upper edge of the right kidney. There are metastases in both lobes of the liver. No extrahepatic distant metastases were found in the patient. Performed surgery: right nephrectomy with resection of the infrarenal inferior vena cava; atypical resection of the right and left lobes of the liver; resection of the right lumbar muscle; paracaval and aortocaval  lymphadenectomy. In a satisfactory condition, the patient was discharged from the department for further chemotherapy at the oncological center at the place of residence.

Based on the rarity of BDC, knowledge about the clinical features, diagnosis, treatment and morphological verification of this tumor will make it possible to identify it and apply the most effective treatment algorithm, as well as accumulate knowledge that allows for more effective treatment.

Keywords:Bellini ductal carcinoma; morphological characteristics; clinic; diagnostics; features of the process course; treatment

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Stepanova Yu.A., Chekhoeva O.A., Gritskevich A.A., Shirokov V.S., Kalinin D.V. Bellini ductal carcinoma: literature review and case report. Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (4): 87–98. DOI: https://doi.org/10.33029/2308-1198-2022-10-4-87-98  (in Russian)

References

1.     Foot N.C., Papanicolaou G.N. Early renal carcinoma in situ detected by means of smears of fixed urinary sediment. JAMA. 1949; 139 (6): 356–8. DOI: https://doi.org/10.1001/jama.1949.02900230010003  

2.     Mancilla-Jimenez R., Stanley R.J., Blath R.A. Papillary renal cell carcinoma: a clinical, radiologic, and pathologic study of 34 cases. Cancer. 1976; 38 (6): 2469–80. DOI: https://doi.org/10.1002/1097-0142(197612)38:6<2469::aid-cncr2820380636>3.0.co;2-r  

3.     Fleming S., Lewi H.J. Collecting duct carcinoma of the kidney. Histopathology. 1986; 10: 1131–41. DOI: https://doi.org/10.1111/j.1365-2559.1986.tb02553.x  

4.     Singh I., Nabi G. Bellini duct carcinoma: review of diagnosis and management. Int Urol Nephrol. 2002; 34 (1): 91–5. DOI: https://doi.org/10.1023/a:1021315130481

5.     Dason S., Allard C., Sheridan-Jonah A., Gill J., Jamshaid H., Aziz T., et al. Management of renal collecting duct carcinoma: a systematic review and the McMaster experience. Curr Oncol. 2013; 20 (3): e223–32. DOI: https://doi.org/10.3747/co.20.1230

6.     Tokuda N., Naito S., Matsuzaki O., Nagashima Y., Ozono S., Igarashi T.; Japanese Society of Renal Cancer. Collecting duct (Bellini duct) renal cell carcinoma: a nationwide survey in Japan. J Urol. 2006; 176 (1): 40–3. DOI: https://doi.org/10.1016/S0022-5347(06)00502-7

7.     Karakiewicz P.I., Trinh Q.D., Rioux-Leclercq N., de la Taille A., Novara G., Tostain J., et al. Collecting duct renal cell carcinoma: a matched analysis of 41 cases. Eur Urol. 2007; 52 (4): 1140–5. DOI: https://doi.org/10.1016/j.eururo.2007.01.070

8.     Wright J.L., Risk M.C., Hotaling J., Lin D.W. Effect of collecting duct histology on renal cell cancer outcome. J Urol. 2009; 182 (6): 2595–9. DOI: https://doi.org/10.1016/j.juro.2009.08.049

9.     Chen J., Cai D., Gong K., Zhu S. Collecting duct carcinoma of the kidney: analysis of 74 cases from multiple centers. Urology. 2022; 164: 163–8. DOI: https://doi.org/10.1016/j.urology.2022.01.032

10. Sui W., Matulay J.T., Robins D.J., James M.B., Onyeji I.C., RoyChoudhury A., et al. Collecting duct carcinoma of the kidney: disease characteristics and treatment outcomes from the National Cancer Database. Urol Oncol. 2017; 35 (9): 540.e13–8. DOI: https://doi.org/10.1016/j.urolonc.2017.04.010

11. Dimopoulos M.A., Logothetis C.J., Markowitz A., Sella A., Amato R., Ro J. Collecting duct carcinoma of the kidney. Br J Urol. 1993; 71 (4): 388–91. DOI: https://doi.org/10.1111/j.1464-410x.1993.tb15978.x

12. Sakaeva D.D., Kunafina R.I., Al’mukhametova G.M., Akchulpanov T.Kh. Experience with the combination of gemcitabine and carboplatin in the treatment of metastatic carcinoma tumor from the collecting ducts (Bellini ducts). Farmateka [Pharmateca]. 2020; 27 (11): 64–7. DOI: https://doi.org/10.18565/pharmateca.2020.11.64-67  (in Russian)

13. Tumors of the urinary system and male genital organs. Morphological diagnostics and genetics: A guide for physicians. In: Yu.Yu. Andreeva, G.A. Frank (eds). Moscow: Prakticheskaya meditsina, 2012: 31–3. (in Russian)

14. Collecting Duct Carcinoma. URL: https://rarediseases.info.nih.gov/diseases/9573/collecting-duct-carcinoma  (date of access March 5, 2022)

15. Mishra A.K., Manikandan R., Dorairajan L.N., Mittal J.K., Rekha J.S. Bellini duct carcinoma: a rare entity. J Clin Diagn Res. 2016; 10 (10): PD01–2. DOI: https://doi.org/10.7860/JCDR/2016/21335.8613  

16. Wang X., Hao J., Zhou R., Zhang X., Yan T., Ding D., et al. Collecting duct carcinoma of the kidney: a clinicopathological study of five cases. Diagn Pathol. 2013; 8: 96. DOI: https://doi.org/10.1186/1746-1596-8-96  

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

Journals of «GEOTAR-Media»