Sarcomatoid carcinoma of the renal pelvis with giant cell tumor-like features: Case report with immunohistochemical findings (original) (raw)
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Sarcomatoid Transitional Cell Carcinoma of the Renal Pelvis
Pathology - Research and Practice, 1996
Sarcomatoid transitional cell carcinoma of the renal pelvis is a rare neoplasm with only 7 well illustrated examples reported. These tumours can assume a partial or complete spindle cell pattern of growth, leading to the erroneous classification as sarcomas. We describe the clinic-pathologic features of five additional examples of sarcomatoid carcinoma of the renal pelvis observed in three males and two females. The age ranged from 65-to-82 years-old (mean 71.6). All these patients were treated by nephrectomy and died of disease between 6 and 20 months (mean 11.2) after the onset of symptoms. An immunohistochemical study demonstrated coexpression of keratins, epithelial membrane antigen and vimentin. The image DNA ploidy of all the tumours showed an aneuploid pattern.
Sarcomatoid renal cell carcinoma with scant carcinomtaous components
International Journal of Urology, 2000
A 30-year-old male underwent radical nephrectomy for a right renal tumor 15 cm in diameter. On microscopic examination of initial 17 sections, the tumor consisted of pleomorphic giant cells and spindle neoplastic cells. There was no carcinomatous component. Immunohistochemically, the neoplastic cells were negative for keratin and epithelial membrane antigen but positive for vimentin. The giant cells were also scatteringly, weakly positive for myoglobin. At that time a diagnosis of rhabdomyosarcoma of the kidney was made. However, further microscopic examination of another eight sections revealed small areas of clear cell-type renal cell carcinoma (RCC) which transited to sarcomatous components and led to a diagnosis of sarcomatoid RCC. The patient underwent three cycles of adjuvant chemotherapy. He has been free of the disease for 14 months after nephrectomy.
Open Journal of Pathology, 2013
Sarcomatoid carcinoma is a rare malignant tumor that has both malignant epithelial and mesenchymal components. We describe a sarcomatoid carcinoma arising in the right renal pelvis of a 68-year-old man. The dominant component of the tumor was osteosarcomatous, but there were also focal carcinomatous areas. The sarcomatous tumor cells produced abundant osteoid matrix surrounded by osteoblastic cells. The carcinomatous tumor cells consisted of papillary urothelial carcinoma. Immunohistochemical assay showed that the sarcomatous tumor cells were positive for vimentin and negative for cytokeratin. The papillary urothelial carcinoma was positive for cytokeratin and negative for vimentin. After surgery, the patient underwent adjuvant chemotherapy. Four months later, he presented with recurrence in the right subphrenic area and metastasis in the right middle lobe of the lung.
Sarcomatoid renal cell carcinoma: Clinicopathologic. A study of 42 cases
Cancer, 1987
Forty-two cases of sarcomatoid renal cell carcinoma were reviewed clinicopathologically. Twenty-four patients were men, and 18 women; average age was 56.2 years (range, 30-81 years). Eight, 9, 13, and 12 cases were Stages I, 11,111, and IV, respectively. Three morphologic patterns of sarcomatoid components were identified: malignant fibrous histiocytomatous (26 cases), fibrosarcomatous (6 cases), and unclassified sarcomatoid (10 cases). Mitotic count, degree of pleomorphism, cellularity, and amount of tumor matrix in the sarcomatoid areas, and similar morphologic parameters in the carcinomatous component all failed to correlate with prognosis, as did tumor size and renal vein involvement by tumor. Clinicopathologic stage was a most significant prognostic factor, with a survival of 49.7 months for Stage I and 6.8 months for combined Stages 11,111, and IV. Tumor necrosis in the sarcomatoid area and proportion of sarcomatoid components were also poor prognostic factors. When these factors were compared to the stage, necrosis was an independent variable, however, proportion of sarcomatoid components was a poor prognostic indicator only for Stages I and 11.
Sarcomatoid Renal Cell Carcinoma: A Rare Case with Review of Literature
Scholars Journal of Medical Case Reports
Sarcomatoid renal cell carcinoma is a rare and highly lethal form of kidney tumor. It is characterised by extensive chromosomal rearrangements. These tumors show microscopic features similar to spindle cell sarcoma with high cellularity and cellular atypia. Majority of cases represent rumours with 100% sarcomatoid pattern and no recognizable epithelial element. We present a case of sarcomatoid renal cell carcinoma to highlight the clinical features and aggressive nature of this tumor.
Annals of Diagnostic Pathology, 2011
Renal cell carcinoma (RCC) with rhabdoid morphology (RCC-RM) is a recently described variant of RCC, which has an aggressive biologic behavior and poor prognosis, akin to sarcomatoid RCC. The current World Health Organization classification of RCC does not include the rhabdoid phenotype as a distinct histologic entity. The aim of this study is to investigate whether RCC-RM represents a dedifferentiation of a classifiable-type World Health Organization RCC or a carcinosarcoma with muscle differentiation. We reviewed 168 cases of RCC obtained between 2003 and 2008. From these cases, 10 (6%) were found to have areas of classic rhabdoid morphology. Immunohistochemistry for cytokeratin, epithelial membrane antigen, desmin, CD10, and CD117 was performed in each case using the labeled streptavidin-biotin method. Rhabdoid differentiation was identified in association with conventional-type RCC (9) and with unclassifiable-type RCC with spindle cell morphology (1). In all cases, both the rhabdoid and nonrhabdoid tumoral areas were positive for cytokeratin and epithelial membrane antigen and negative for desmin. Cytokeratin positivity in the rhabdoid areas was focal. In cases associated with conventional-type RCC, CD10 was positive in both the rhabdoid and nonrhabdoid foci. CD117 was negative in these tumors. The unclassifiable-type RCC with spindle cell morphology was negative for both CD10 and CD117. The similar immunophenotype between the rhabdoid and nonrhabdoid tumoral foci supports the origin of the rhabdoid cells from the classifiabletype RCC. Areas of rhabdoid morphology do not represent muscle metaplastic differentiation. Renal cell carcinoma with rhabdoid morphology may represent a dedifferentiation of a classifiable-type RCC, similar to that of sarcomatoid differentiation. The recognition of RCC-RM is important as it allows for the inclusion of these high-grade malignancies into a category associated with poor prognosis despite lacking the spindle cell component classically identified as sarcomatoid change.
Papillary Type Renal Cell Carcinoma with Sarcomatoid Differentiation
Scholars journal of medical case reports, 2022
Renal cell carcinoma is the most common renal tumor in adult population. Sarcomatoid differentiation of renal cell carcinoma is quite aggressive in nature and has poor prognosis. In this study, a case of 69-year-old female patient who initially presented with hematuria was discussed.
Journal of Kidney Cancer and VHL, 2016
Mucinous tubular and spindle cell carcinoma (MTSCC) is a recent entity introduced in the World Health Organization 2004 Classification. It is a tumour of low malignant potential. MTSCC is a subtype of renal cell carcinoma (RCC), which is characterized by a polymorphous histology, wherein the spindled epithelial cell is an inherent carcinomatous component. We report the case of a 57-year-old man presenting with loin pain and dragging sensation. Imaging revealed a large mass arising from the left kidney. Radical nephrectomy was performed, and histopathology revealed spindle cell elements of MTSCC with low-grade cytology, which occasionally blended with tubular structures in variable mucinous stroma admixed with spindle sarcomatoid cells with marked nuclear pleomorphism, associated with significant necrosis and mitoses of up to 5/10 high-power field. A final diagnosis of MTSCC along with high-grade areas consistent with sarcomatoid dedifferentiation was made. Sarcomatoid dedifferentiation has been well documented in various subtypes of RCC, and its presence signifies a worse prognosis in RCC.