Unclassified renal cell carcinoma: Difference between revisions

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#redirect [[Kidney_tumours#Unclassified_renal_cell_carcinoma]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Unclassified_renal_cell_carcinoma_-_thyroid-like_and_clear_cell-like_--_low_mag.jpg
| Width      =
| Caption    = Unclassified renal cell carcinoma with thyroid-like and clear cell-like areas. [[H&E stain]].
| Synonyms  =
| Micro      = One of the following: (1) a combination of other RCC histologic types, (2) "non-identifiable" pattern/unrecognizable cell type (3) pure [[sarcomatoid RCC]] without an identifiable (epithelioid) RCC subtype
| Subtypes  =
| LMDDx      = [[clear cell renal cell carcinoma]], [[collecting duct carcinoma]], undifferentiated carcinoma extending into kidney, [[kidney metastasis]], retroperitoneal [[sarcoma]], newly described renal tumour or emerging entity - see ''[[Vancouver classification]]'', [[collision tumour]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = kidney mass
| Grossing  = [[partial nephrectomy grossing]], [[total nephrectomy for tumour grossing]]
| Staging    = [[kidney cancer staging]]
| Site      = [[kidney]] - see ''[[kidney tumours]]''
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = poor
| Other      =
| ClinDDx    = other renal tumours
| Tx        = excision if feasible
}}
'''Unclassified renal cell carcinoma''', abbreviated '''URCC''', is a [[malignant]] epithelial tumour arising from the [[kidney]] parenchyma, i.e. a [[renal cell carcinoma]], that cannot be further classified.


==General==
*Uncommon.
*A [[WHO]] classification ''diagnosis of exclusion''.
*Worse prognosis than [[clear cell renal cell carcinoma]].<ref name=pmid17822461>{{Cite journal  | last1 = Karakiewicz | first1 = PI. | last2 = Hutterer | first2 = GC. | last3 = Trinh | first3 = QD. | last4 = Pantuck | first4 = AJ. | last5 = Klatte | first5 = T. | last6 = Lam | first6 = JS. | last7 = Guille | first7 = F. | last8 = de La Taille | first8 = A. | last9 = Novara | first9 = G. | title = Unclassified renal cell carcinoma: an analysis of 85 cases. | journal = BJU Int | volume = 100 | issue = 4 | pages = 802-8 | month = Oct | year = 2007 | doi = 10.1111/j.1464-410X.2007.07148.x | PMID = 17822461 }}</ref>
*High variation in the prevalence (when comparing institutions); this suggests a lack of uniformity in the diagnosis of this subtype.<ref name=pmid17822461/>
==Gross==
*Mass lesion arising from the kidney - solid and/or cystic.
**Confined to kidney or predominantly within the kidney.
==Microscopic==
Features:
*Malignant tumour that is one of the following:<ref name=Ref_WMSP293>{{Ref WMSP|293}}</ref><ref name=pmid22404824>{{Cite journal  | last1 = Lopez-Beltran | first1 = A. | last2 = Kirkali | first2 = Z. | last3 = Montironi | first3 = R. | last4 = Blanca | first4 = A. | last5 = Algaba | first5 = F. | last6 = Scarpelli | first6 = M. | last7 = Yorukoglu | first7 = K. | last8 = Hartmann | first8 = A. | last9 = Cheng | first9 = L. | title = Unclassified renal cell carcinoma: a report of 56 cases. | journal = BJU Int | volume = 110 | issue = 6 | pages = 786-93 | month = Sep | year = 2012 | doi = 10.1111/j.1464-410X.2012.10934.x | PMID = 22404824 }}</ref>
*#A combination of other RCC histologic types (~35% of cases of URCC).
*#Has a "non-identifiable" pattern/unrecognizable cell type (~60% of cases of URCC).
*#Pure [[sarcomatoid RCC]] without an identifiable (epithelioid) RCC subtype (~5% of cases of URCC).<ref name=pmid22404824/>
DDx:
*[[Clear cell renal cell carcinoma]].
*[[Collecting duct carcinoma]].
*Undifferentiated carcinoma.
*[[Kidney metastasis]] - typically metastatic carcinoma.
*Retroperitoneal [[sarcoma]], e.g. [[pleomorphic undifferentiated sarcoma]].
*Newly described renal tumour or emerging entity - see ''[[Vancouver classification]]''.
*[[Collision tumour]], e.g. [[urothelial carcinoma]] and identifiable [[renal cell carcinoma]].
===Images===
====Case 1====
<gallery>
Image: Unclassified renal cell carcinoma - thyroid-like with myomatous stroma -- low mag.jpg | URCC - low mag.
Image: Unclassified renal cell carcinoma - thyroid-like -- intermed mag.jpg | URCC - intermed. mag.
Image: Unclassified renal cell carcinoma - thyroid-like -- high mag.jpg | URCC - high mag.
Image: Unclassified renal cell carcinoma - thyroid-like and clear cell-like -- low mag.jpg | URCC - low mag.
Image: Unclassified renal cell carcinoma - thyroid-like and clear cell-like -- intermed mag.jpg | URCC - intermed. mag.
Image: Unclassified renal cell carcinoma - thyroid-like and clear cell-like - alt -- intermed mag.jpg | URCC - intermed. mag.
Image: Unclassified renal cell carcinoma - mixed clear cell and thyroid-like  -- low mag.jpg | URCC - low mag.
Image: Unclassified renal cell carcinoma - mixed clear cell and thyroid-like -- intermed mag.jpg | URCC - intermed. mag.
Image: Unclassified renal cell carcinoma - mixed clear cell and thyroid-like -- high mag.jpg | URCC - high mag.
</gallery>
====Case 2====
<gallery>
Image: Unclassified renal cell carcinoma in BHD -- low mag.jpg | URCC in [[BHD]] - low mag.
Image: Unclassified renal cell carcinoma in BHD -- intermed mag.jpg | URCC in [[BHD]] - intermed. mag.
Image: Unclassified renal cell carcinoma in BHD -- high mag.jpg | URCC in BHD - high mag.
Image: Unclassified renal cell carcinoma in BHD -- very high mag.jpg | URCC in BHD - very high mag.
Image: Unclassified renal cell carcinoma in BHD - b -- intermed mag.jpg | URCC in BHD - intermed. mag.
Image: Unclassified renal cell carcinoma in BHD - b -- high mag.jpg | URCC in BHD - high mag.
Image: Unclassified renal cell carcinoma in BHD - b -- very high mag.jpg | URCC in BHD - very high mag.
</gallery>
==IHC==
*Pankeratin +ve.
*[[PAX8]] +ve.
*Vimentin +ve/-ve.
*p63 -ve.<ref>{{Cite journal  | last1 = Carvalho | first1 = JC. | last2 = Thomas | first2 = DG. | last3 = McHugh | first3 = JB. | last4 = Shah | first4 = RB. | last5 = Kunju | first5 = LP. | title = p63, CK7, PAX8 and INI-1: an optimal immunohistochemical panel to distinguish poorly differentiated urothelial cell carcinoma from high-grade tumours of the renal collecting system. | journal = Histopathology | volume = 60 | issue = 4 | pages = 597-608 | month = Mar | year = 2012 | doi = 10.1111/j.1365-2559.2011.04093.x | PMID = 22260386 }}</ref>
**Usually +ve in [[UCC]].
==See also==
*[[Kidney tumours]].
==References==
{{Reflist|2}}
[[Category:Kidney tumours]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]
Retrieved from "https://librepathology.org/wiki/Unclassified_renal_cell_carcinoma"