PMC3715973_01
Bisected kidney showing a well-defined mass with extensive necrosis (bold arrow) and a small focus of viable tumor. The adjacent kidney involved diffusely by prostatic carcinoma metastasis appears grossly firm and whitish (thin arrow). Also seen here is a firm whitish irregular deposit (asterix) adjacent to the hilar region. The same kidney also shows a simple cyst (arrow head)
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PMC3715973_01_IJMPO-34-21-g001.jpg
F1
The radical nephrectomy specimen on gross revealed a well-circumscribed necrotic tumor measuring 5.7 cm x 5.2 cm x 4.8 cm involving the upper two-thirds of the kidney ([Figure 1], thick arrow). The adjacent cortical area appeared firm and pale white ([Figure 1], thin arrow). A smooth cyst measuring 4 cm x 3.5 cm x 3 cm was seen at the lower pole ([Figure 1], arrow head). A firm nodule with a grey-white cut-surface measuring 1.2 cm in diameter was seen adherent to the kidney at the hilum ([Figure 1], asterix).
Microscopic and immunohistochemical examination revealed areas with diffuse interstitial infiltration by prostatic adenocarcinoma (a, hematoxylin and eosin, original magnification, x40), which was CK7 negative (a inset, indirect immunoperoxidase) and separate foci of conventional clear cell renal carcinoma (b, hematoxylin and eosin, original magnification, x100). The prostatic adenocarcinoma was negative for CD10 immunomarker (c, indirect immunoperoxidase) in contrast to the renal carcinoma, which was CD10 positive (d, indirect immunoperoxidase)
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F2
The metastatic prostatic adenocarcinoma was negative for CK7, CK20, CD10, HMWCK, vimentin and PSA [Figure 2a-d].