Abnormal Cystic Tumor in a Patient with Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome: Evidence of a Precursor Lesion?

The hereditary leiomyomatosis and renal cell cancer (HLRCC) association is a rare syndrome caused by mutation of the Kreb’s cycle enzyme, fumarate hydratase (FH). It is characterized by unusually aggressive type 2 papillary renal cell histology. FH is responsible for catalyzing the conversion of fum...

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Main Authors: Benjamin T. Ristau, Sonal N. Kamat, Tatum V. Tarin
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Urology
Online Access:http://dx.doi.org/10.1155/2015/303872
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author Benjamin T. Ristau
Sonal N. Kamat
Tatum V. Tarin
author_facet Benjamin T. Ristau
Sonal N. Kamat
Tatum V. Tarin
author_sort Benjamin T. Ristau
collection DOAJ
description The hereditary leiomyomatosis and renal cell cancer (HLRCC) association is a rare syndrome caused by mutation of the Kreb’s cycle enzyme, fumarate hydratase (FH). It is characterized by unusually aggressive type 2 papillary renal cell histology. FH is responsible for catalyzing the conversion of fumarate to malate. Its absence leads to a state of “pseudohypoxia,” inducing hypoxia inducible factor 1α (HIF-1α) and leading to increased growth factor transcription (e.g., vascular endothelial growth factor, VEGF; glucose transporter 1, GLUT1). Ultimately, this results in tumorigenesis. We present a patient who was diagnosed with HLRCC and underwent bilateral nephrectomies. One of the nephrectomy specimens was notable for benign cystic lesions that stained positive immunohistochemically for succinated proteins, a finding only noted in FH-deficient cells. Thus, we posit a potential precursor lesion to type 2 papillary renal cell carcinoma in the HLRCC syndrome.
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spelling doaj-art-7593c47d6edd4e29a9c4256a3cfea03c2025-08-20T03:35:22ZengWileyCase Reports in Urology2090-696X2090-69782015-01-01201510.1155/2015/303872303872Abnormal Cystic Tumor in a Patient with Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome: Evidence of a Precursor Lesion?Benjamin T. Ristau0Sonal N. Kamat1Tatum V. Tarin2Deparment of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA 15219, USADepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA 15219, USADeparment of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA 15219, USAThe hereditary leiomyomatosis and renal cell cancer (HLRCC) association is a rare syndrome caused by mutation of the Kreb’s cycle enzyme, fumarate hydratase (FH). It is characterized by unusually aggressive type 2 papillary renal cell histology. FH is responsible for catalyzing the conversion of fumarate to malate. Its absence leads to a state of “pseudohypoxia,” inducing hypoxia inducible factor 1α (HIF-1α) and leading to increased growth factor transcription (e.g., vascular endothelial growth factor, VEGF; glucose transporter 1, GLUT1). Ultimately, this results in tumorigenesis. We present a patient who was diagnosed with HLRCC and underwent bilateral nephrectomies. One of the nephrectomy specimens was notable for benign cystic lesions that stained positive immunohistochemically for succinated proteins, a finding only noted in FH-deficient cells. Thus, we posit a potential precursor lesion to type 2 papillary renal cell carcinoma in the HLRCC syndrome.http://dx.doi.org/10.1155/2015/303872
spellingShingle Benjamin T. Ristau
Sonal N. Kamat
Tatum V. Tarin
Abnormal Cystic Tumor in a Patient with Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome: Evidence of a Precursor Lesion?
Case Reports in Urology
title Abnormal Cystic Tumor in a Patient with Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome: Evidence of a Precursor Lesion?
title_full Abnormal Cystic Tumor in a Patient with Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome: Evidence of a Precursor Lesion?
title_fullStr Abnormal Cystic Tumor in a Patient with Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome: Evidence of a Precursor Lesion?
title_full_unstemmed Abnormal Cystic Tumor in a Patient with Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome: Evidence of a Precursor Lesion?
title_short Abnormal Cystic Tumor in a Patient with Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome: Evidence of a Precursor Lesion?
title_sort abnormal cystic tumor in a patient with hereditary leiomyomatosis and renal cell cancer syndrome evidence of a precursor lesion
url http://dx.doi.org/10.1155/2015/303872
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AT tatumvtarin abnormalcystictumorinapatientwithhereditaryleiomyomatosisandrenalcellcancersyndromeevidenceofaprecursorlesion