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)
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