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Chromphobic Eosinophilic

PK_Chicago
Posts: 29
Joined: Mar 2012

In January 2012 - I went in for a CT scan related to a colon issue I was having and they found a 14.5cm mass in my left kidney. I had no symptoms, no history and none of the risk factors. From the CT scan it appeared that the tumor was contained in the meaty part of my kidney. I had a radical nephrectomy and a colon resection done 5 days later. When they removed the kidney they also removed two lymph nodes. The first pathology report from the hospital where the surgery was done showed the cancer to be clear cell and that it was also present on one of the two lymph nodes. I researched a bit and chose an oncologist who specialized in kidney cancer at a large research hospital. They reviewed my CT scan and surgical slides and they classified the subtype as chromophobe eosinophilic EVCHRCC and no cells on the lymph node. Now I had two answers! At this point I went for another opinion at another large research hospital and they confirmed the subtype as chromophobe eosinophilic. I guess I’m lucky to live in Chicago where there are numerous large research hospitals!

That all being said – I was wondering what makes this subtype have a “better prognosis”? In all my web research they never get into any details.

Anyone have any further information? Websites? Etc?

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

PK, it's not surprising that you've not found a lot of info. "Classic" Chromophobe RCC was recognised as a distinct sub-type as recently as 1985 (that seems like only yesterday to some of us) and the nature of the eosinophilic variant is still being teased out - see, e.g.

http://www.nature.com/modpathol/journal/v18/n2/full/3800286a.html

in which the conclusion includes this:

"In summary, we found with interphase cytogenetics that eosinophilic and classic chromophobe renal cell carcinomas have similarly frequent losses of chromosomes 1, 2, 6, 10, and 17 and renal oncocytomas usually show normal complements of these chromosomes, with occasional loss of chromosome 1. This does not lend support to the hypothesis that chromophobe renal cell carcinoma and renal oncocytoma are closely related, or that eosinophilic chromophobe renal cell carcinoma is a transition form between chromophobe renal cell carcinoma and renal oncocytoma."

There are little bits on Steve Dunn's website, e.g. at

http://cancerguide.org/rcc_subtypes.html

None of this, of course, butters many parsnips for us. I apologise in anticipation if this is carrying coals to Newcastle (like shipping ice to Antarctica) but if you haven't been there, you might want to delve into

http://pathologyoutlines.com/kidneytumormalignant.html

which contains a vast amount of info. including loads on chromophobe RCC. I can't pretend to have digested much of that and if you do so and find useful material you could do me the favour of guiding me to helpful bits, even just to (dis)confirm the impression I have that (unless it goes sarcomatoid) this cell-type is slower growing and less aggressive, leading to frequently being detected only after the tumour is much larger than with other cell types. Also, it may shed light on why the prognosis tends to be more favourable?

I hope something here may prove useful in some way.

PK_Chicago
Posts: 29
Joined: Mar 2012

Thanks for the info! I'll look into it!

PK_Chicago
Posts: 29
Joined: Mar 2012

I also noticed your photo shows you golfing...

I had my surgery in January and the warm weather in Chicago makes me want to take the clubs out - but I feel like My abdominal strength isn't there yet (I had a colon resection AND the kidney removed in the same day!)

How long was it before you hit the links?

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

PK I honestly can't remember exactly. I re-started naughtily while walking round with my playing partners, borrowing their clubs for a few drives. I think I was back to playing 4 rounds a week after around 2 months. Glad to hear it's warming up in Chicago. It's shot up to 10C here now but there was a strong cold Carnoustie wind blowing on the links this morning.

I know what you mean about the core strength. I'm doing plenty of rowing at the moment and getting back into decent condition - such a pity I've now got to go through it all again with a repeat of the open surgery I had in December and will be off golf, lifting, rowing and running for another spell :-(

The consolation is knowing that being fairly fit again already will make it easier to do it all again.

Incidentally, my tumour cell type is also chromophobe until, alas, it turned mostly sarcomatoid :((

PK_Chicago
Posts: 29
Joined: Mar 2012

I've joined a health club - but have basically been walking and using the elliptical - I'll have to try rowing! How did you know it turned sarcomatiod? Through a scan?

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

Following a radical nephrectomy in December for a much smaller tumour than yours - a mere 9cm - my path report came back showing stage 4, grade 4 with the microscopic study of the tumour cells revealing residual chromophobe but now (then, rather) "predominently sarcomatoid". This is why I'm having another open op two weeks from today to remove a new tumour which will almost certainly be sarcomatoid and therefore best removed sooner rather than later.

Joining a health club is a good idea. I've got a good elliptical at home and a Concept 2D rowing machine which is ultra-convenient. I've rowed on and off for about 60 years and really love it. There's nothing like rowing a dinghy on a rough sea or a clinker 8 on a tidal river but a good rowing machine feels a lot like the real thing, although you don't 'catch crabs' get 'bell-strokes' or feel the wind and spray on your face. It's a superb all-body workout and, like the elliptical, no impact, unlike knocking out the miles running on roads.

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