Collecting duct carcinoma

A rare type of kidney cancer

Classification
External resources

Collecting duct carcinoma (CDC), also known as Bellini duct carcinoma, is a rare and aggressive form of renal cell carcinoma (RCC) that originates in the collecting ducts of the kidney. This type of cancer is characterized by its distinct histological features and poor prognosis compared to other types of renal cell carcinoma.

Pathophysiology

Collecting duct carcinoma arises from the collecting ducts of the kidney, which are part of the renal medulla. These ducts are responsible for the final concentration of urine before it is excreted from the body. The cancer is believed to originate from the epithelial cells lining these ducts. Unlike other forms of renal cell carcinoma, CDC is not associated with common genetic mutations such as those found in clear cell renal cell carcinoma.

Clinical Presentation

Patients with collecting duct carcinoma often present with symptoms similar to other types of kidney cancer, including hematuria (blood in the urine), flank pain, and a palpable mass in the abdomen. Due to its aggressive nature, CDC may also present with symptoms related to metastasis, such as bone pain or respiratory symptoms if the cancer has spread to the lungs.

Diagnosis

The diagnosis of collecting duct carcinoma is typically made through a combination of imaging studies and histopathological examination. Computed tomography (CT) scans and magnetic resonance imaging (MRI) are commonly used to identify the presence of a renal mass. A definitive diagnosis is made through a biopsy of the tumor, which reveals the characteristic histological features of CDC, including high-grade nuclear atypia and a desmoplastic stromal reaction.

Treatment

Treatment options for collecting duct carcinoma are limited due to its rarity and aggressive nature. Surgical resection, such as nephrectomy, is the primary treatment for localized disease. However, due to the high likelihood of metastasis, systemic therapies are often required. Traditional chemotherapy regimens used for other types of renal cell carcinoma are generally ineffective against CDC. Research into targeted therapies and immunotherapy is ongoing, with some promising results in clinical trials.

Prognosis

The prognosis for patients with collecting duct carcinoma is generally poor, with a high rate of recurrence and metastasis. The five-year survival rate is significantly lower than that of other types of renal cell carcinoma. Early detection and treatment are crucial for improving outcomes, but the aggressive nature of the disease often leads to late-stage diagnosis.

Related pages

• Renal cell carcinoma
• Kidney cancer
• Nephrectomy
• Chemotherapy