View source for ALK translocation renal cell carcinoma

{{ Infobox diagnosis
| Name       = {{PAGENAME}}
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| Synonyms   =
| Micro      = mixed morphology, +/-papillae, +/-myxoid change
| Subtypes   =
| LMDDx      = [[papillary renal cell carcinoma]], [[unclassified renal cell carcinoma]], [[clear cell renal cell carcinoma]], [[SMARCB1-deficient renal medullary carcinoma]]
| Stains     =
| IHC        = ALK +ve
| EM         =
| Molecular  = ALK rearranagement
| IF         =
| Gross      =
| Grossing   = [[total nephrectomy for tumour grossing]], [[partial nephrectomy grossing]]
| Staging    = [[kidney cancer staging]]
| Site       = [[kidney]] - see ''[[kidney tumours]]''
| Assdx      =
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| Prevalence = very rare
| Bloodwork  =
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| ClinDDx    =
| Tx         = may respond to ALK inhibitors
}}
'''ALK translocation renal cell carcinoma''', also '''ALK-rearranged renal cell carcinoma''' and '''ALK-positive renal cell carcinoma''', is a type of [[renal cell carcinoma]] recognized by the WHO.

==General==
*Extremely rare.
**One case was identified in 829 consecutively screened Korean patients.<ref name=pmid24255633>{{Cite journal  | last1 = Lee | first1 = C. | last2 = Park | first2 = JW. | last3 = Suh | first3 = JH. | last4 = Nam | first4 = KH. | last5 = Moon | first5 = KC. | title = ALK-Positive Renal Cell Carcinoma in a Large Series of Consecutively Resected Korean Renal Cell Carcinoma Patients. | journal = Korean J Pathol | volume = 47 | issue = 5 | pages = 452-7 | month = Oct | year = 2013 | doi = 10.4132/KoreanJPathol.2013.47.5.452 | PMID = 24255633 }}</ref>
**A second series described 8 in 276 cases on a microarray.<ref name=pmid38039739>{{cite journal |authors=Doğan K, Onder E |title=ALK-rearranged renal cell carcinoma (ALK-RCC): Evaluation of histomorphological and immunohistochemical features by analysis of 276 renal cell carcinoma cases in Turkey |journal=Pathol Res Pract |volume=253 |issue= |pages=154951 |date=January 2024 |pmid=38039739 |doi=10.1016/j.prp.2023.154951 |url=}}</ref>
**In 2016, less than 17 cases reported.<ref name=pmid27554841>{{Cite journal  | last1 = Jeanneau | first1 = M. | last2 = Gregoire | first2 = V. | last3 = Desplechain | first3 = C. | last4 = Escande | first4 = F. | last5 = Tica | first5 = DP. | last6 = Aubert | first6 = S. | last7 = Leroy | first7 = X. | title = ALK rearrangements-associated renal cell carcinoma (RCC) with unique pathological features in an adult. | journal = Pathol Res Pract | volume = 212 | issue = 11 | pages = 1064-1066 | month = Nov | year = 2016 | doi = 10.1016/j.prp.2016.07.015 | PMID = 27554841 }}</ref>
*May respond to [[ALK inhibitors]] such as alectinib<ref name=pmid29685646>{{Cite journal  | last1 = Pal | first1 = SK. | last2 = Bergerot | first2 = P. | last3 = Dizman | first3 = N. | last4 = Bergerot | first4 = C. | last5 = Adashek | first5 = J. | last6 = Madison | first6 = R. | last7 = Chung | first7 = JH. | last8 = Ali | first8 = SM. | last9 = Jones | first9 = JO. | title = Responses to Alectinib in ALK-rearranged Papillary Renal Cell Carcinoma. | journal = Eur Urol | volume = 74 | issue = 1 | pages = 124-128 | month = 07 | year = 2018 | doi = 10.1016/j.eururo.2018.03.032 | PMID = 29685646 }}</ref> or crizotinib.<ref name=pmid27554841>{{Cite journal  | last1 = Jeanneau | first1 = M. | last2 = Gregoire | first2 = V. | last3 = Desplechain | first3 = C. | last4 = Escande | first4 = F. | last5 = Tica | first5 = DP. | last6 = Aubert | first6 = S. | last7 = Leroy | first7 = X. | title = ALK rearrangements-associated renal cell carcinoma (RCC) with unique pathological features in an adult. | journal = Pathol Res Pract | volume = 212 | issue = 11 | pages = 1064-1066 | month = Nov | year = 2016 | doi = 10.1016/j.prp.2016.07.015 | PMID = 27554841 }}</ref>

==Microscopic==
Features:
*Mix of morphologies - including:
**[[Papillary renal cell carcinoma]].<ref name=pmid24255633/>
**[[Renal cell carcinoma with rhabdoid morphology|Rhabdoid change]].<ref name=pmid26017874>{{Cite journal  | last1 = Kuroda | first1 = N. | last2 = Karashima | first2 = T. | last3 = Inoue | first3 = K. | last4 = Kasajima | first4 = A. | last5 = Ohe | first5 = C. | last6 = Kawakami | first6 = F. | last7 = Mikami | first7 = S. | last8 = Matsuura | first8 = K. | last9 = Moriyama | first9 = M. | title = Review of renal cell carcinoma with rhabdoid features with focus on clinical and pathobiological aspects. | journal = Pol J Pathol | volume = 66 | issue = 1 | pages = 3-8 | month = Mar | year = 2015 | doi =  | PMID = 26017874 }}</ref> 
**[[Renal cell carcinoma with sarcomatoid differentiation|Sarcomatoid change]].
**"[[Unclassified renal cell carcinoma]]".

DDx:
*[[Papillary renal cell carcinoma]] - especially what used to be known as "type 2".<ref name=pmid24255633/>
*[[Unclassified renal cell carcinoma]]
*[[Renal medullary carcinoma]].
*[[Clear cell renal cell carcinoma]].<ref name=pmid38039739/>

==IHC==
Features:<ref>{{Cite journal  | last1 = Jeanneau | first1 = M. | last2 = Gregoire | first2 = V. | last3 = Desplechain | first3 = C. | last4 = Escande | first4 = F. | last5 = Tica | first5 = DP. | last6 = Aubert | first6 = S. | last7 = Leroy | first7 = X. | title = ALK rearrangements-associated renal cell carcinoma (RCC) with unique pathological features in an adult. | journal = Pathol Res Pract | volume = 212 | issue = 11 | pages = 1064-1066 | month = Nov | year = 2016 | doi = 10.1016/j.prp.2016.07.015 | PMID = 27554841 }}</ref>
*ALK +ve.
*PAX8 +ve.
*Vimentin +ve (diffuse).
*CK7 +ve (focal).
*[[SMARCB1]] normal nuclear staining.{{fact}}

==See also==
*[[Vancouver classification]].
*[[Kidney tumours]].
*[[Lung carcinoma with ALK rearrangement]].

==References==
{{Reflist|1}}

[[Category:Kidney tumours]]