Primary collision renal tumor of papillary renal cell carcinoma within an oncocytoma: emergency presentation of a rare entity.

BACKGROUND: The coexistence of an oncocytoma and a papillary renal cell carcinoma (PRCC) in the same neoplastic mass constitute a collision tumor and is an extremely rare entity. Until now, only six incidentally diagnosed cases have been reported, concerning patients older than 65 years. CASE REPORT: A 57-year-old man was admitted to the Emergency Department with acute pain and anemia, due to renal hematoma following rupture of such a neoplastic collision mass. The patient underwent an emergency nephrectomy, which revealed a 10.6 cm oncocytoma and a 1.3 cm PRCC. He had an uncomplicated postoperative recovery and remained healthy at the 65-month follow-up, the longest of all previous cases. CONCLUSION: While prognosis appears favorable, the current report shows that these collision tumors may cause emergency and dangerous medical conditions that deserve prompt treatment. HIPPOKRATIA 2017, 21(2): 105-107.

Enzymatic function of multiple origins regulates the progression of colorectal cancer and the development of metastases.

Enzymes play a crucial role in the progression of colorectal cancer and the development of metastases. They facilitate malignant cell invasion through the degradation of the extracellular matrix, the rupture of the basement membrane and the derangement of cell-cell adhesion. Furthermore, they promote tumour cell migration and support the evolution of metastatic lesions in the liver and other organs, through multiple molecular mechanisms, including growth factor release and angiogenesis. Urokinase plasminogen activator system, matrix metalloproteinases, heparanase and autocrine motility factor constitute important enzymatic complexes which assist colorectal cancer growth, with potential clinical applications in the diagnosis and treatment of the disease.

Current diagnostic and therapeutic approaches for colorectal cancer liver metastasis.

Colorectal cancer is the second leading cause of cancer death in the developed world, due to formation of distant metastases. The liver is a primary target organ of metastatic lesions, which substantially influence the morbidity of the disease. Prompt diagnosis of colorectal liver metastases leads to early treatment, which favours a better prognosis. Consequently, the diagnostic process has shifted from traditional clinical and biochemical procedures to technologically advanced imaging modalities, such as CT, MRI, FDG-PET and PET-CT. However, the only current curative therapeutic approach is the surgical resection of metastases, using the new methods of tissue excision and haemostasis. New therapeutic modalities like cryo- or radiofrequency ablation and portal vein embolisation as well as pharmaceutical innovations such as hepatic arterial infusion chemotherapy, isolated hepatic perfusion and contemporary chemotherapeutic regimens have emerged. While still under evaluation, they present promise for the future treatment of unresectable liver metastases.