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Eosinophilic solid and cystic renal cell carcinoma is a recently named kidney cancer, almost always in women, made of pink cells in solid areas and cysts. It was first seen in people with tuberous sclerosis and then found on its own, it is nearly always confined to the kidney, and surgery cures it in almost every reported case.
The 2022 WHO classification introduced eosinophilic solid and cystic renal cell carcinoma as a new morphologically defined type (Moch 2022). It was first described in patients with tuberous sclerosis complex; a search for a sporadic counterpart found 16 morphologically identical tumours, all in women without clinical tuberous sclerosis, median age 57, with solid and macrocystic growth, voluminous eosinophilic cytoplasm with granular stippling, hobnail cyst lining, nuclear PAX8, a CK20-positive and CK7-negative phenotype and no CD117; 13 of 16 were stage pT1 (Am J Surg Pathol 2016). In 19 further cases, all women, median age 55 and median size 31 mm, CK20 was positive in 74 percent, 89 percent were pT1, and 15 of 16 with follow-up were alive without disease (Am J Surg Pathol 2017). Sporadic cases carry somatic TSC1 or TSC2 mutations, the same pathway as the syndromic form.
How it differs from its parent: a female-only series, tuberous sclerosis biology (mTOR pathway), CK20 positivity and an indolent course with rare metastasis; it is distinguished from oncocytoma and chromophobe carcinoma by the cysts, the stippled cytoplasm and CK20.
How common: no registry share.
Treatment: partial nephrectomy; the mTOR inhibitor everolimus, approved for tuberous sclerosis-associated tumours, is the rational choice for the rare metastatic case, without trial evidence in this type.
Rare: 16 sporadic cases, all in women, median age 57 (Am J Surg Pathol 2016), and 19 further cases, all women, median age 55 (Am J Surg Pathol 2017). No registry share exists for a type named in 2022.
Renal cell carcinoma comes from the kidney's filtering cortex, urothelial cancer from the lining of the collecting system and bladder, and the adrenal on top hosts cortical and medullary (neuroblastoma) tumours.
Same organ: Collecting duct carcinoma of the kidney, Renal medullary carcinoma (SMARCB1-deficient), TFE3-rearranged (translocation) renal cell carcinoma, Fumarate hydratase-deficient renal cell carcinoma (HLRCC-associated), Succinate dehydrogenase-deficient renal cell carcinoma, Mucinous tubular and spindle cell carcinoma of the kidney, Clear cell papillary renal cell tumour, Urothelial carcinoma of the urethra, Squamous cell carcinoma of the urethra, Adenocarcinoma of the urethra (including clear cell adenocarcinoma), Melanoma of the urethra, Non-muscle-invasive bladder cancer, Muscle-invasive and advanced bladder cancer, Bladder & urothelial cancer, Clear cell renal cell carcinoma, Papillary renal cell carcinoma, Chromophobe renal cell carcinoma, Renal cell carcinoma, Wilms tumour (nephroblastoma), Neuroblastoma (paediatric), Low-risk neuroblastoma (INRG very low and low risk, including stage MS), Intermediate-risk neuroblastoma, High-risk neuroblastoma, Adrenocortical carcinoma, Pheochromocytoma and paraganglioma (PPGL), Urethral cancer, Penile cancer, Localised penile cancer (organ-confined, node-negative), Node-positive and metastatic penile cancer, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable), Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable), Hereditary pheochromocytoma and paraganglioma (SDHx, VHL, RET, NF1, MAX and TMEM127), Metastatic pheochromocytoma and paraganglioma
No subtypes recorded beyond the ones named in the family strip above.
Partial nephrectomy; everolimus is the rational choice for rare metastatic disease on the tuberous sclerosis biology, without trial evidence.
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Query for this cancer: (TITLE:"Eosinophilic solid and cystic renal cell carcinoma" OR ABSTRACT:"Eosinophilic solid and cystic renal cell carcinoma" OR TITLE:"ESC RCC" OR ABSTRACT:"ESC RCC" OR TITLE:"Eosinophilic, solid and cystic renal cell carcinoma" OR ABSTRACT:"Eosinophilic, solid and cystic renal cell carcinoma" OR TITLE:"TSC-associated eosinophilic renal cell carcinoma syndromic form" OR ABSTRACT:"TSC-associated eosinophilic renal cell carcinoma syndromic form") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Eosinophilic solid and cystic renal cell carcinoma, not a curated reading list.
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7.5 mg (mild), 5 mg (moderate), 2.5 mg (severe).
High blood sugar as a side effect of drugs that block the PI3K/AKT pathway, because the same pathway carries insulin's signal in muscle and liver. It is the main reason these otherwise effective breast cancer drugs are hard to give.
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