Immunohistochemical basis for adjuvant anti-angiogenic targeted therapy for renal carcinoid: initial case report - PubMed (original) (raw)

Case Reports

Immunohistochemical basis for adjuvant anti-angiogenic targeted therapy for renal carcinoid: initial case report

David S Finley et al. Urol Oncol. 2011 Jan-Feb.

Abstract

Objectives: To evaluate the immunohistochemical profile of a carcinoid (low grade neuroendocrine tumor of the kidney) from a patient with lymph node positive disease who remains disease free for 31 months after radical nephrectomy, lymph node dissection, and adjuvant therapy with sunitinib malate.

Methods: Immunohistochemical staining was performed for chromogranin, synaptophysin, CD31, VEGF, HIF-1α, HIF-2, and Glut-1. Staining was evaluated in 3 high-power fields and samples scored as strongly positive (3+), moderately positive (2+), weakly positive (1+), or negative (0). A clear cell renal cell carcinoma was used as positive control.

Results: Immunohistochemical staining was strongly positive VEGF, weak to moderately positive for HIF-2, and negative for HIF-1α and Glut-1.

Conclusions: Our case of primary renal carcinoid stained intensely for VEGF and HIF-2, consistent with a VHL-HIF1-HIF2-Glut1 independent pathway for VEGF activation. These data suggest that like other neuroendocrine tumors, primary renal carcinoid is a potential target for anti-angiogenic therapy with sunitinib.

Copyright © 2011 Elsevier Inc. All rights reserved.

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Figures

Figure 1

Figure 1

a–d. A: Contrast enhanced CT, arterial phase (axial view) showing an enhancing 3.5 × 4.0 × 3.5cm central hilar mass without adenopathy. B: 10 minute delayed phase, axial view. C: Arterial phase, coronal view D: Arterial phase, coronal view.

Figure 2

Figure 2

H&E and immunostains of the neuroendocrine carcinoma and a clear cell renal cell carcinoma (positive control) demonstrating mildmoderate positive staining HIF2 (B) and strong positive staining for VEGF (D).

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