case_images: PMC10999537_01
case_images: The clinical course schedule of this patient showing the treatment route received by the patient.
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case_images: The treatment route followed by the patient is summarized in  Figure 1 . The presence of mutations in these 20 genes suggests enrichment in pathways related to platinum drug resistance, PI3K-Akt signaling pathway, and nucleotide excision repair. These findings provide potential implications for targeted therapies and insights into the molecular mechanisms underlying the development and progression of AMLEC ( Supplementary Figure S1 ).
case_images: Radiological and microscopic findings. (A) On computed tomography, a cystic density lesion measuring 63 mm x 39 mm was found at the upper part of the right kidney (red arrow). (B) Photomicrograph showing epithelial cysts lined by cuboidal to hobnailed cells (H&E100X, H&E200X).
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case_images: The border of the cyst was still clear, and it protruded outward locally ( Figure 2A ). The cyst wall measured approximately 0.2cm-0.3cm in thickness ( Figure 2B ).
case_images: Immunohistochemical findings. Immunohistochemistry for AE1/AE3, PAX-8, ER, PR, CD10, WT1, HMB45, Melan A, SMA, Desmin, Ki67 and inhibin-a expression in AMLEC lesions (from right to light, from top to below) (H&E40X).
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case_images: f3
case_images: Immunohistochemically, the epithelial cells lining the cyst wall showed diffuse expressed of AE1/AE3 and PAX-8 ( Figure 3 ), suggesting that the cysts may have resulted from cystic dilatation of collecting ducts that invaginated into the tumor. Melan A ( Figure 3 ), markers of melanocytic differentiation, were most intense and concentrated in the subepithelial cells, while HMB45 showed patchy labeling in the exterior muscle-predominant AML component. Meanwhile, Figure 3 ) labeling less than 1% of neoplastic cells. Furthermore, CA IX, CD117 (c-kit), CD34 (endothelial markers), and inhibin-a did not label any of the three components of the tumor.