Sarcomatoid chromophobe renal cell carcinoma with heterologous sarcomatoid elements. Sarcomatoid renal cell carcinoma metastasis to the penis. Sarcomatoid renal cell carcinoma srcc is an aggressive tumor variant thought to arise predominantly from differentiation of clear cell carcinoma. Expression of muc1 ema and ecadherin in renal cell. Renal pelvis squamous cell carcinoma with sarcomatoid. Sarcomatoid renal cell carcinoma with rhabdoid features. May occur in any of the standard subtypes of renal cell carcinoma. Sarcomalike histology in a renal tumor is not a distinct entity but a pathway of transformation dedifferentiation in subtypes of renal cell carcinoma rcc cancer 2005. To the best of our knowledge, this is the first reported case of a chromophobe renal cell carcinoma with sarcomatoid and collecting duct carcinoma components. Department of pathology, hospital tenon, huep, sorbonne. Sarcomatoid dedifferentiation is a histological feature that can be found in approximately 10% of tumors in any rcc subtype and confers. Tissue microarrays tmas were constructed from 45 cases of sarcrcc and 45 cases of sarcuc of the lower urinary tract, with an additional 11 sarcucs of the upper tract. Definition of sarcomatoid renal cell carcinoma sarcomatoid renal cell carcinoma srcc is currently defined in the 2004 world health organization who classification of renal tumors as any.
Cell proliferation activity and expression of cellcell adhesion factors ecadherin, apha, beta, and gammacatenin, and p120 in sarcomatoid renal cell carcinoma. Renal cell carcinoma rcc with sarcomatoid differentiation belongs to the most aggressive clinicopathologic phenotypes of rcc. Sarcomatoid variant of urothelial carcinoma of the renal. Dedifferentiated chromophobe renal cell carcinoma with massive osteosarcomalike divergent differentiation. A case of sarcomatoid renal cell carcinoma is reported with light, immunohistochemical and electron microscopic findings. Numerous grading systems have been proposed, initially focusing upon a constellation of cytological features and more recently on nuclear morphology. Spindle cell proliferation within clear cell renal cell carcinoma ccrcc is usually considered as a sarcomatoid differentiation. These tumors are aggressive malignancies with poor prognosis and a high. Sarcomatoid renal cell carcinoma is a rare tumour of the kidney whichaccounts for l%of renal neoplasms inadults and has been reported in ito 6. We report herein the clinical, histological, and immunohistochemical features of a case of sarcomatoid chromophobe renal cell carcinoma. Clear cell renal cell carcinoma rcc was the most enhancing tumor subtype in the corticomedullary phase.
Sarcomatoid squamous cell carcinoma of the cervix is a rare tumor. A few reports of srcc associated with nonclear cell. Sarcomatoid renal cell carcinomas srcc may develop when one of the more common histologic subtypes of renal cell carcinoma degenerates into a sarcoma. It is not a distinct histologic entity as it can be found in any subtypes of renal cell. A novel prognostic model for patients with sarcomatoid renal cell. This tumor consists of ordinary renal cell carcinoma associated with a sarcomalike. Only 16 cases have so far been reported in literature.
Histopathology and immunohistochemical examination of the radical nephrectomy specimen showed squamous cell carcinoma with sarcomatoid transformation in the renal pelvis. Grading of renal cell carcinoma rcc has been recognised as a prognostic. Gira fa, barbieri a, fellegara g, zompatori m, corradi d. Excludes lymphoma and leukemia m9590 m9992 and kaposi sarcoma m9140. Sarcomatoid renal cell carcinoma is not a distinct histologic entity and represents highgrade transformation in different subtypes of renal cell carcinoma. Renal cell carcinoma rcc 8312 is a group term for glandular. Correlation of computed tomography characteristics of. Sarcomatoid dedifferentiation in renal cell carcinoma mdpi. Renal cell carcinoma rcc with sarcomatoid differentiation srcc is a highly. Variables for each identified patient we abstracted data on age, race, gender, treatment, lymph node. Sarcomatoid renal cell carcinoma srcc is also known as spindlecell carcinoma, anaplastic carcinoma, and carcinosarcoma. Sarcomatoid renal cell carcinoma surgical pathology. Extremely rare divergent differentiation in sarcomatoid variant of renal cell carcinoma developing ip. The pathology and molecular genetics of sarcomatoid renal cell.
We report a case of 50 years old male who presented with complaints of. Discussion sarcomatoid carcinoma of the kidney is a highly malignant tumor with a biphasic morphology. A small subset of renal neoplasms composed of socalled small blue cells, such as lymphoma, synovial sarcoma, neuroblastoma, small cell carcinoma, and. Background sarcomatoid renal cell carcinomas srcc are composed of two cell populations, a sarcomatous component sc and a carcinomatous component cc. Recommendations for the reporting of surgically resected. Represents a form of high grade transformation, not a distinct subtype of renal cell carcinoma. Pulmonary sarcomatoid carcinoma is a diagnostically challenging group of tumors. Mucinous tubular and spindle cell carcinoma mtscc is a rare subtype of renal cell carcinoma rcc, that is included in the 2004 who classification of rcc. Spindle cell carcinoma of the kidney and its variant. It is characterized by a high propensity for primary metastasis and limited therapeutic options due to its relative resistance to established systemic targeted therapy. Protocol for the examination of biopsy specimens from. We report a case of 50 years old male who presented with complaints of haematuria and abdominal pain. Sarcomatoid renal cell carcinoma is a highly aggressive tumor.
Considerable progress has been made in the treatment of patients with renal cell carcinoma, with innovative surgical and systemic strategies revolutionising the management of this disease. A sarcomatoid component can occur in all histologic subtypes of renal cell carcinoma rcc and indicates an aggressive tumor. We report a case of a 71yearold man with a large leftsided renal mass. Its a rare histologic subtype of nonsmall cell lung cancer. Manjeet umar, alpesh mahesh parmar, santosh umar, ritambra nada, abhishek thakur2019.
Extremely rare divergent differentiation in sarcomatoid. It is an aggressive tumor variant thought to arise predominantly from differentiation of clear cell carcinoma. Should not be reported as the subtype of renal cell carcinoma. Renal cell carcinoma, chromophobe type, with collecting. Pathology outlines sarcomatoid renal cell carcinoma. Sarcomatoid variant of urothelial carcinoma svuc of the renal pelvis is a rare entity.
Use of pax8 and gata3 in diagnosing sarcomatoid renal cell. The tumour consisted of typical clear cells of renal cell carcinoma. Rhabdoid features have been recently identified as a morphologic variant of renal cell carcinoma rcc associated with aggressive behavior. To the best of our knowledge, around 25 cases of this neoplasm have been reported in the literature to date, most of. Sarcomatoid and rhabdoid renal cell carcinoma pathology. Histopathology in surgically treated renal cell carcinoma. Mucinous tubular and spindle cell carcinoma wikipedia. Renal cell carcinoma rcc, including sarcomatoid rcc, has the ability to metastasize to various locations including the lung, bone, lymph nodes, and liver. Sarcomatoid variant of renal cell carcinoma introduction.
Sarcomatoid renal cell carcinoma srcc with rhabdoid features is a rare tumor with aggressive behavior and poor prognosis. We report here one such tumor occurring in a 54yearold postmenopausal woman. The amount of sarcomatoid tissue may be of prognostic relevance and should be quantitated as a percentage. A few reports of srcc associated with nonclear cell tumors led to the presumption that srcc may arise. We studied 2381 patients treated with radical nephrectomy for rcc between 1970 and 2000.
All tumors with a sarcomatoid component were classified as nuclear grade 4. Grading of renal cell carcinoma delahunt 2019 histopathology. Sarcomatoid renal cell carcinoma radiology reference. Four cases of medullary renal cell carcinoma were categorized as collecting duct renal cell carcinoma. Highdose interleukin 2 in patients with metastatic renal cell carcinoma with sarcomatoid features. Sarcomatoid renal cell carcinoma international journal. Sarcomatoid variant of renal cell carcinoma introduction pages with reference to book, from 219 to 220 muhammad muzaffar, sajid mushtaq, zahid latif, ezra nigar, nadira mamoon department of. However, there are limited data on these markers in sarcomatoid renal cell carcinoma sarcrcc and sarcomatoid urothelial carcinoma sarcuc. Reported to occur in 58% of renal cell carcinomas less common in our experience. Sarcomatoid differentiation in renal cell carcinoma. Printable sarcomatoid renal cell carcinoma surgical. Sarcomatoid renal cell carcinoma srcc is currently defined in the 2004 world health organization who classification of renal tumors as any histologic type of renal cell carcinoma rcc containing. Regional and distant lymph nodes as identified in summary staging manual. Sarcomatoid differentiation represents a histological variant found in 5% to 8% of all renal cell carcinomas rccs.
The clinical and radiographic presentation, staging methods, prognosis, and management of these tumors are. Sarcomatoid carcinoma is a phenotype of renal cell carcinoma which is independent of the histologic subtype and signals a poor prognosis. Grading of renal cell carcinoma rcc has been recognised as a prognostic factor for almost 100 years. Most trials report on a poor median overall survival of 5 to 12 months. The yellow background of the tumor is consistent grossly with a clear cell renal cell carcinoma. Pdf sarcomatoid renal cell carcinoma sufian zaheer. Though there are multiple areas suspicious for sarcomatoid renal cell carcinoma, part c is most suspicious as this shows a more whitish, fleshy cut surface that appears to be different from the surrounding tumor.
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