obsolete oncocytic neoplasm

Based on the provided context, it appears that there are several types of oncocytic neoplasms that have been described in medical literature.

Oncocytoma

• Oncocytoma is a benign renal neoplasm that is an increasing concern for urologists, oncologists, and nephrologists due to its difficult differential diagnosis [1].
• It is characterized by an enlarged, polygonal cell with distinct cell borders and abundant granular, eosinophilic cytoplasm [3][5].
• Oncocytoma is the most commonly resected benign epithelial neoplasm of the kidney [2].

Eosinophilic Variant of Chromophobe Renal Cell Carcinoma (eo-ChRCC)

• This type of tumor has overlapping features with oncocytoma and is considered a "gray zone" oncocytic tumor [15].
• It is characterized by cytologically low-grade cells with homogeneous architectural patterns mimicking SDH-deficient renal cell carcinoma, oncocytoma, and low-grade oncocytic tumors [11].

Hybrid Oncocytic Tumors

• This term refers to eosinophilic/oncocytic tumors with borderline features that occur in a hereditary setting, such as Birt-Hogg-Dubé syndrome [14].
• Hybrid oncocytic tumors are considered a distinct entity and have been postulated to represent a low-grade oncocytic tumor [12][13].

Low-Grade Oncocytic Renal Tumors

• These tumors include well-recognized entities, such as renal oncocytoma (RO) and eosinophilic variant of chromophobe renal cell carcinoma (eo-ChRCC), as well as a group of "gray zone" oncocytic tumors [13][15].
• Low-grade oncocytic renal tumors have overlapping features between RO and eo-ChRCC that create ongoing diagnostic and classification problems [15].

It's worth noting that the descriptions of these oncocytic neoplasms are not exhaustive, and further research is needed to fully understand their characteristics and implications.

Common Signs and Symptoms

Oncocytic neoplasms, also known as oncocytomas, are rare tumors that can occur in various organs, including the kidneys, adrenal glands, salivary glands, thyroid, kidney, and pancreas. While they are generally benign, some symptoms may be associated with these tumors.

• Abdominal or flank pain: Some people with Renal oncocytoma will experience abdominal or flank pain [4].
• Blood in the urine: Blood in the urine (hematuria) is a possible symptom of renal oncocytomas [10].
• Abdominal mass: An abdominal mass may be palpable in some cases [4].
• Weight loss and fatigue: Unexplained weight loss and persistent tiredness are non-specific symptoms that can occur in various conditions, including oncocytic neoplasms [10].

Other Possible Symptoms

In addition to the above-mentioned symptoms, other possible signs and symptoms of oncocytic neoplasms may include:

• Muscle weakness: Muscle weakness on one side of the face or numbness in part of the face can occur if the tumor affects the salivary glands [11].
• Trouble swallowing: Trouble opening the mouth widely or trouble swallowing can be symptoms of a salivary gland tumor [11].

Important Note

It is essential to note that these symptoms are non-specific and can be associated with various other conditions. A definitive diagnosis of oncocytic neoplasm can only be made through histopathological examination.

References:

[4] - Some people with Renal oncocytoma will have abdominal or flank pain; blood in the urine; and/or an abdominal mass. [10] - Unfortunately, kidney cancer is often hard to diagnose, as it doesn't have clear signs or symptoms in its early stages. Over time, the following may develop: Blood in your urine, which may appear pink, red or cola colored. Pain in your back or side that does not go away. Loss of appetite. Unexplained weight loss. Persistent tiredness. Fever. [11] - Symptoms. Signs and symptoms of a salivary gland tumor may include: A lump or swelling on or near the jaw or in the neck or mouth. Muscle weakness on one side of the face. Numbness in part of the face. Ongoing pain near a salivary gland. Trouble opening the mouth widely. Trouble swallowing.

Diagnostic Challenges in Oncocytic Neoplasms

Oncocytic neoplasms, including renal oncocytoma and chromophobe renal cell carcinoma, can be challenging to diagnose accurately using traditional diagnostic tests. The following points highlight the limitations of certain diagnostic methods:

• Immunohistochemistry: While immunohistochemistry can be useful in selected cases, it may not provide sufficient information for a definitive diagnosis, especially when dealing with entities that require molecular confirmation [4].
• Molecular techniques: Growing use of molecular techniques is essential in determining some renal tumor entities. However, these methods may not always be available or reliable [14].
• Ultrasound imaging and computed tomography (CT): These imaging modalities can help detect and differentiate renal cell carcinoma subtypes, angiomyolipoma, and oncocytoma, but they may not provide a definitive diagnosis [6].

Diagnostic Accuracy Concerns

The accuracy of diagnostic tests for oncocytic neoplasms is a concern. A study reported that in one series on renal mass biopsy, the diagnosis of "oncocytic renal neoplasm" was provided in 11.5% of cases [11]. Moreover, these tests offer only limited diagnostic accuracy [10,12,13].

Need for Reevaluation and Algorithmic Approach

There is a need to reevaluate the histological criteria of adenomas when it comes to oncocytic lesions in the kidney [8]. A practical clinically relevant algorithmic approach to classifying tumors within the low-grade oncocytic family of renal neoplasia has been proposed, including a proposal for compressing terminology for evolving categories without sacrificing prognostic relevance [12].

References:

[4] by DA Athanazio · 2021 · Cited by 41 [6] by TJ van Oostenbrugge · 2018 · Cited by 126 [8] by C Topalidis · 2024 [10] by F Trevisani · 2022 · Cited by 16 [11] by F Trevisani · 2022 · Cited by 16 [12] by TJ van Oostenbrugge · 2018 · Cited by 126 [13] by DA Athanazio · 2021 · Cited by 41

Based on the provided context, it appears that there are some outdated information regarding drug treatment for oncocytic neoplasms.

According to search result [2], examples of drugs used in the past include sorafenib, gefitinib, axitinib, motesanib, sunitinib, and pazopanib. However, it is essential to note that these treatments may not be relevant or effective for modern oncocytic neoplasm cases.

Additionally, search result [5] mentions levothyroxine treatment after radioactive iodine therapy, but this seems to be related to thyroid cancer treatment rather than oncocytic neoplasms specifically.

It's also worth noting that search result [7] mentions immunotherapy as a promising approach for metastatic renal oncocytoma, but it does not provide specific information about drug treatments for oncocytic neoplasms.

In summary, while there are some outdated references to drug treatments for oncocytic neoplasms, the most recent and relevant information suggests that these treatments may not be effective or relevant for modern cases. However, further research is needed to confirm this.

References:

• Search result [2]: Examples of drugs used in the past include sorafenib, gefitinib, axitinib, motesanib, sunitinib, and pazopanib.
• Search result [5]: Levothyroxine treatment after radioactive iodine therapy (related to thyroid cancer treatment)
• Search result [7]: Immunotherapy as a promising approach for metastatic renal oncocytoma

The differential diagnosis of an obsolete oncocytic neoplasm involves identifying and distinguishing it from other types of tumors that may have similar characteristics.

According to recent studies [9][10], the differential diagnosis for an oncocytoma on resection includes an eosinophilic variant of chromophobe renal cell carcinoma, which often has a more solid architecture as well as subtle nuclear irregularity, enlargement, and perinuclear haloes. Additionally, a low-grade oncocytic renal cell carcinoma, unclassified type, may resemble an oncocytoma in terms of its histological features.

In the past [13], renal oncocytoma and chromophobe renal cell carcinoma were considered unique renal tumors, but since then, criteria for diagnosis have evolved, and additional distinct tumor subtypes have been recognized. The differential diagnosis now involves a range of entities, including clear cell renal cell carcinoma (CCRCC), epithelioid angiomyolipoma (EAML), and hybrid oncocytic/chromophobe tumor (HOCT) of the kidney.

The pathological diagnosis of an oncocytic renal tumor is often challenging [14], and its differential diagnosis requires careful consideration of various factors, including histological features, immunohistochemical stains, and clinical context. In some cases, adjuvant therapy may be considered based on the differential diagnosis, such as for oncocytic tumors with involvement of fat or blood vessels.

Imaging studies can also assist in the differential diagnosis between renal oncocytic tumors and RCC [6], but traditional MRI or multiphasic CT imaging does not always provide a clear distinction. Therefore, a comprehensive approach that takes into account multiple factors is essential for accurate differential diagnosis.

References: [9] Renal oncocytoma is a benign (noncancerous) growth of the kidney. [10] The differential diagnosis for an oncocytoma on resection includes an eosinophilic variant of chromophobe renal cell carcinoma, which often has a more solid architecture as well as subtle nuclear irregularity, enlargement, and perinuclear haloes (A); a low-grade oncocytic renal cell carcinoma, unclassified type, which resembles an oncocytoma. [13] Renal oncocytoma and chromophobe renal cell carcinoma were accepted as unique renal tumors in the late 1990s. Since their formal description, criteria for diagnosis have evolved and additional distinct tumor subtypes originally considered as one these two entities are now recognized. [14] Pathological diagnosis of oncocytic renal tumor is usually difficult task, and their differential diagnosis involves chromophobe renal cell carcinoma (ChRCC), renal oncocytoma (RO), clear cell renal cell carcinoma (CCRCC), epithelioid angiomyolipoma (EAML), etc.