We wish to report on a case of renal-cell carcinoma (RCC) occurring in a 9-yr-old female child, recently diagnosed by fine-needle aspiration (FNA) biopsy. This girl was admitted with abdominal pain in the right lower quadrant. A right abdominal mass was detected, and abdominal CT scan showed an expansive lesion in the suprarenal region, extending into the right iliac fossa. Abdominal NMR in the superior pole of the right kidney showed a heterogeneous and apparently well-encapsulated mass of 7.0 ฯซ 5.0 cm, causing renal compression. Slight ectasia of the excretory system of the same kidney was also noted. Percutaneous transabdominal FNA biopsy under ultrasound guidance was performed.
The aspirate was bloody, with a few large tridimensional groups. Cells bordering those groups were cylindrical with eccentric and slightly irregular nuclei with prominent nucleoli. Cytoplasm was clear, sometimes with microvacuoles, and had very well-defined borders. The hypothesis of lymphoma or another small round blue cell neoplasm was excluded, and the diagnosis of an epithelial neoplasm of clear-cell type, probably of renal origin (RCC), was advanced. Surgery was performed with right nephro-uretectomy, and a renal-cell carcinoma of clear-cell type (grade II in the Furham classification, pT3NxMx; stage II) was diagnosed.
Renal-cell carcinoma in infancy and up to the second decade is very rare. 1 Most of the literature regarding RCC in children consists of isolated case reports or small series of cases. [2][3][4][5] Recently, Daniel et al. 6 described a series of 22 cases. Cytology reports of RCC in childhood are even rarer. 1 On the other hand, fine-needle aspiration cytology (FNAC) is now a well-established technique in the routine preoperative diagnosis of childhood tumors.
Renal-cell carcinoma needs to be distinguished, mainly, from Wilm's tumor. 1 Clinical overlap is common, and further investigations are needed in order to arrive at a specific diagnosis. Imagiology most of the time is not distinctive enough, and so FNAC is extremely useful in the