Collecting Duct Carcinoma: A Rare Entity

Ferdinant Martinus Djawa, Anny Setijo Rahaju



Collecting duct carcinoma is a rare and highly aggressive subtype of renal cell carcinoma. The incidence rate is less than 1-2% of all renal tumors and usually, affect middle-aged adult, commonly in men. We reported a 76-year-old man complains of an intermittent painless gross hematuria, abdominal mass and left flank pain for approximately three months. The CT abdomen showed a slightly enhancing solid mass in the left kidney and para-aorta lymphadenopathy. Cut surfaces of the kidney showed a solid-cystic and ill-defined greyish-white tumor. Microscopically, tumor formed solid sheets and tubulopapillary structures lined by neoplastic cells, hobnailing nuclei, abnormal mitotic, and a desmoplastic stroma with lymphoplasmacytic infiltration, and the immunochemical profile were PAX8 (+) /p63 (-). Based on these findings, the diagnosis was a collecting duct carcinoma. This tumor arising from the collecting duct of Bellini in the renal medulla, accounts for less than 1-2% of all renal masses and important to be distinguished from other tumors due to differences in prognosis and therapeutic. Histopathological examination is needed to establish the diagnosis. A case of collecting duct carcinoma that occurred in a 76-year-old man has been reported. A definitive diagnosis can only be done with a detailed histopathological examination for patient management benefits.

Keywords          : renal cell carcinoma, collecting duct carcinoma, urothelial carcinoma, PAX8, p63


renal cell carcinoma, collecting duct carcinoma, urothelial carcinoma, PAX8, p63

Full Text:



Albadine, R., Schultz, L., Illei, P., Ertoy, D., Hicks, J., Sharma, R., … Netto, G. J. (2010). PAX8 (+)/p63 (−) Immunostaining Pattern in Renal Collecting Duct Carcinoma (CDC). The American Journal of Surgical Pathology, 34(7), 965–969.

Ciszewski, S., Jakimów, A., & Smolska-Ciszewska, B. (2015). Collecting (Bellini) duct carcinoma: A clinical study of a rare tumor and review of the literature. Canadian Urological Association Journal, 9(9–10), 589.

Dall’Oglio, M. F., Antunes, A. A., Pompeo, A. C., Mosconi, A., Leite, K. R. M., & Srougi, M. (2008). Prognostic relevance of the histological subtype of renal cell carcinoma. International Braz J Urol, 34(1), 3–8.

Gupta, R., Billis, A., Shah, R. B., Moch, H., Osunkoya, A. O., Jochum, W., … Amin, M. B. (2012). Carcinoma of the Collecting Ducts of Bellini and Renal Medullary Carcinoma. The American Journal of Surgical Pathology, 36(9), 1265–1278.

Harbin, A. C., Styskel, B. A., Patel, V., Wang, H., & Eun, D. D. (2015). Collecting Duct Renal Cell Carcinoma Found to Involve the Collecting System During Partial Nephrectomy: A Case Report. Journal of Kidney Cancer and VHL, 2(3), 134.

Hu, Y., Zhou, H., Wang, G., Song, Z., Zhao, C., & Wang, Y. (2015). Collecting duct carcinoma of the kidney: A case report. Oncology Letters, 9(6), 2902–2904.

Jung, H. J., Oh, H. K., & Shin, H. S. (2017). Collecting Duct Carcinoma (Bellini Duct Carcinoma) Presented as a Renal Cyst. The Korean Journal of Urological Oncology, 15(3), 187–191.

Kawaguchi, M., Ito, K., Shimazaki, H., & Asano, T. (2017). A Case of Metastatic Collecting Duct Carcinoma Whose Massive Skull Bone Metastasis was Prominently Reossified by Gemcitabine Plus Cisplatin Chemotherapy Combined with Zoledronic Acid. Urology Case Reports, 15, 14–16.

Kobayashi, N., Matsuzaki, O., Shirai, S., Aoki, I., Yao, M., & Nagashima, Y. (2008). Collecting duct carcinoma of the kidney: an immunohistochemical evaluation of the use of antibodies for differential diagnosis. Human Pathology, 39(9), 1350–1359.

Konjengbam, L., & Singh, T. (2017). Collecting duct carcinoma: Sarcomatoid variant - A rare entity. Journal of Medical Society, 31(1), 52.

Liu J, Li Y, Su Z, Duqun Chen, Ni L, Mao X, Y. S., and L. Y. (2016). SM Gr up SM Journal of Case Reports Sickness. 2(2), 1–2.

López, J. I., Larrinaga, G., Kuroda, N., & Angulo, J. C. (2015, April 1). The normal and pathologic renal medulla: A comprehensive overview. Pathology Research and Practice, Vol. 211, pp. 271–280.

Mishra, A. K., Manikandan, R., Dorairajan, L. N., Mittal, J. K., & Rekha, J. S. (2016). Bellini duct carcinoma: A rare entity. Journal of Clinical and Diagnostic Research, 10(10).

Muglia, V. F., & Prando, A. (2015). Renal cell carcinoma: histological classification and correlation with imaging findings. Radiologia Brasileira, 48(3), 166–174.

Petejova, N., & Martinek, A. (2016). Renal cell carcinoma: Review of etiology, pathophysiology, and risk factors. Biomedical Papers, Vol. 160, pp. 183–194.

Seo, A. N., Yoon, G., & Ro, J. Y. (2017). Clinicopathologic and molecular pathology of collecting duct carcinoma and related renal cell carcinomas. Advances in Anatomic Pathology, Vol. 24, pp. 65–77.

Shuch, B., Amin, A., Armstrong, A. J., Eble, J. N., Ficarra, V., Lopez-Beltran, A., … Kutikov, A. (2015, January 1). Understanding pathologic variants of renal cell carcinoma: Distilling therapeutic opportunities from biologic complexity. European Urology, Vol. 67, pp. 85–97.

Sui, W., Matulay, J. T., Robins, D. J., James, M. B., Onyeji, I. C., Roy Choudhury, A., … DeCastro, G. J. (2017). Collecting duct carcinoma of the kidney: Disease characteristics and treatment outcomes from the National Cancer Database. Urologic Oncology: Seminars and Original Investigations, 35(9), 540.e13-540.e18.

Wu, J., Zhu, Q., Zhu, W., Chen, W., & Wang, S. (2015). Comparative study of CT appearances in mucinous tubular and spindle cell carcinoma and collecting duct carcinoma of the kidney. British Journal of Radiology, 88(1056).

Zheng, I., Alameddine, M., Tan, Y., Moghadamyeghaneh, Z., Jue, J. S., Yusufali, A., … Ciancio, G. (2017). Collecting Duct Carcinoma of the Native Kidney in a Renal Transplant Recipient. Case Reports in Transplantation, 2017, 1–6.