PMC5871886_01
Tumor morphology and IHC results as discussed in the text. Pseudo-papillae and perivascular pseudo-rosettes (a-c), papillae (d), solid foci and papillae (e), microcysts (f), spindle cell foci and pseudo-papillae (g), pure spindle cell areas (h), eosinophilic cytoplasmic inclusions (arrows in i). Immunohistochemical analysis demonstrates negative staining for SDHA (j) and SDHB (k). Internal controls show SDHA and SDHB staining in nonneoplastic tissue
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Fig1
Examples of the described morphologies are depicted in Fig. 1 a-i. This was confirmed (Fig. 1j, k) and the diagnosis was amended to SDH-deficient RCC.
Tumor response to therapeutic treatments. Prior to treatment with PD-1 inhibitor, chest and abdominal PET-CT scans demonstrated peritoneal, retroperitoneal, subcutaneous, and pulmonary metastases. a Table of the longest axial diameter (LD) measurements (mm) of length (L), width (W), height (H), based on RECIST and calculated volume estimates of 5 target lesions taken during the course of the disease. b Time course of CT evaluation of tumor response (RECIST scores from Fig. 2a) with relation to various treatments. An extrapolated point was obtained by projecting initial tumor growth to the date of commencement of the first TKI therapy (sunitinib). The resulting portion of the graph is indicated with broken lines. c CT image examples of a target right pelvic peritoneum lesion. A 27 June 2016, prior to commencement of PD-1 inhibitor trial. A 12 September 2016, during PD-1 inhibitor trial. C 12 January 2017, following sunitinib and pazopanib treatment
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Fig2
Details of the tumor response to these treatments are shown in Fig. 2.