Difference between revisions of "Renal cell carcinoma with sarcomatoid differentiation"
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'''Renal cell carcinoma with sarcomatoid differentiation''' is a malignant epithelial derived [[kidney tumour]] with malignant mesenchymal differentiation. | '''Renal cell carcinoma with sarcomatoid differentiation''' is a malignant epithelial derived [[kidney tumour]] with malignant mesenchymal differentiation. | ||
These tumours are '''not''' recognized as a distinct type of renal cell carcinoma; they are classified by the non-sarcomatous component. If a renal tumour is purely sarcomatous it is ''[[renal cell carcinoma, unclassified]]''. | These tumours are '''not''' recognized as a distinct type of renal cell carcinoma;<ref name=pmid22234634>{{Cite journal | last1 = Shuch | first1 = B. | last2 = Bratslavsky | first2 = G. | last3 = Linehan | first3 = WM. | last4 = Srinivasan | first4 = R. | title = Sarcomatoid renal cell carcinoma: a comprehensive review of the biology and current treatment strategies. | journal = Oncologist | volume = 17 | issue = 1 | pages = 46-54 | month = | year = 2012 | doi = 10.1634/theoncologist.2011-0227 | PMID = 22234634 }}</ref> they are classified by the non-sarcomatous component. If a renal tumour is purely sarcomatous it is ''[[renal cell carcinoma, unclassified]]''. | ||
'''Sarcomatoid renal cell carcinoma''', abbreviated '''sarcomatoid RCC''', redirects here. | '''Sarcomatoid renal cell carcinoma''', abbreviated '''sarcomatoid RCC''', redirects here. | ||
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*Not recognized as a distinct entity in 2004 WHO classification.<ref name=pmid16442207>{{Cite journal | last1 = Lopez-Beltran | first1 = A. | last2 = Scarpelli | first2 = M. | last3 = Montironi | first3 = R. | last4 = Kirkali | first4 = Z. | title = 2004 WHO classification of the renal tumors of the adults. | journal = Eur Urol | volume = 49 | issue = 5 | pages = 798-805 | month = May | year = 2006 | doi = 10.1016/j.eururo.2005.11.035 | PMID = 16442207 }}</ref> | *Not recognized as a distinct entity in 2004 WHO classification.<ref name=pmid16442207>{{Cite journal | last1 = Lopez-Beltran | first1 = A. | last2 = Scarpelli | first2 = M. | last3 = Montironi | first3 = R. | last4 = Kirkali | first4 = Z. | title = 2004 WHO classification of the renal tumors of the adults. | journal = Eur Urol | volume = 49 | issue = 5 | pages = 798-805 | month = May | year = 2006 | doi = 10.1016/j.eururo.2005.11.035 | PMID = 16442207 }}</ref> | ||
**It is considered an indicator of progression. | **It is considered an indicator of progression. | ||
**Previously considered a distinct entity.<ref name=pmid16442207/><ref name=pmid10080595>{{Cite journal | last1 = Cangiano | first1 = T. | last2 = Liao | first2 = J. | last3 = Naitoh | first3 = J. | last4 = Dorey | first4 = F. | last5 = Figlin | first5 = R. | last6 = Belldegrun | first6 = A. | title = Sarcomatoid renal cell carcinoma: biologic behavior, prognosis, and response to combined surgical resection and immunotherapy. | journal = J Clin Oncol | volume = 17 | issue = 2 | pages = 523-8 | month = Feb | year = 1999 | doi = | PMID = 10080595 | URL = http://jco.ascopubs.org/content/17/2/523.full }}</ref> | **Previously considered a distinct entity.<ref name=pmid22234634/><ref name=pmid16442207/><ref name=pmid10080595>{{Cite journal | last1 = Cangiano | first1 = T. | last2 = Liao | first2 = J. | last3 = Naitoh | first3 = J. | last4 = Dorey | first4 = F. | last5 = Figlin | first5 = R. | last6 = Belldegrun | first6 = A. | title = Sarcomatoid renal cell carcinoma: biologic behavior, prognosis, and response to combined surgical resection and immunotherapy. | journal = J Clin Oncol | volume = 17 | issue = 2 | pages = 523-8 | month = Feb | year = 1999 | doi = | PMID = 10080595 | URL = http://jco.ascopubs.org/content/17/2/523.full }}</ref> | ||
*Tend to present at higher stage. | *Tend to present at higher stage. | ||
*Worse prognosis when adjusted for [[cancer staging|stage]]. | *Worse prognosis when adjusted for [[cancer staging|stage]]. | ||
Revision as of 21:16, 16 June 2015
Renal cell carcinoma with sarcomatoid differentiation is a malignant epithelial derived kidney tumour with malignant mesenchymal differentiation.
These tumours are not recognized as a distinct type of renal cell carcinoma;[1] they are classified by the non-sarcomatous component. If a renal tumour is purely sarcomatous it is renal cell carcinoma, unclassified.
Sarcomatoid renal cell carcinoma, abbreviated sarcomatoid RCC, redirects here.
General
Features:[2]
- Not recognized as a distinct entity in 2004 WHO classification.[3]
- Tend to present at higher stage.
- Worse prognosis when adjusted for stage.
- ISUP nucleolar grade (Fuhrman grade) 4 by definition.
Microscopic
Features:[2]
- Renal cell carcinoma.
- Sarcomatoid component:
- Fibrosarcoma - most common.
- Undifferentiated - common.
- Rhabdomyosarcoma - very rare.
Notes:
- In essence, any kidney tumour with spindle cells should make one think of this.[5]
- Rhabdoid change in renal cell carcinoma is probably analogous to sarcomatoid change.[6]
DDx:
- Retroperitoneal sarcoma.
- Renal mucinous tubular and spindle cell carcinoma.
Images
Case 1
RCC with sarc. diff. - intermed. mag. (WC)
RCC with sarc. diff - high mag. (WC)
RCC with sarc. diff. - very high mag. (WC)
CCRCC - intermed. mag. (WC)
CCRCC - high mag. (WC)
CCRCC - very high mag. (WC)
Case 2
ChRCC with SD - low mag.
ChRCC with SD - intermed. mag.
ChRCC with SD - high mag.
ChRCC with SD - intermed. mag.
ChRCC with SD - high mag.
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- Classified by the underlying renal cell carcinoma, e.g. clear cell renal cell carcinoma.
- If only a sarcomatous component is present these are labeled renal cell carcinoma, unclassified.
- Always ISUP nucleolar grade 4.
See also
References
- ↑ 1.0 1.1 Shuch, B.; Bratslavsky, G.; Linehan, WM.; Srinivasan, R. (2012). "Sarcomatoid renal cell carcinoma: a comprehensive review of the biology and current treatment strategies.". Oncologist 17 (1): 46-54. doi:10.1634/theoncologist.2011-0227. PMID 22234634.
- ↑ 2.0 2.1 de Peralta-Venturina, M.; Moch, H.; Amin, M.; Tamboli, P.; Hailemariam, S.; Mihatsch, M.; Javidan, J.; Stricker, H. et al. (Mar 2001). "Sarcomatoid differentiation in renal cell carcinoma: a study of 101 cases.". Am J Surg Pathol 25 (3): 275-84. PMID 11224597.
- ↑ 3.0 3.1 Lopez-Beltran, A.; Scarpelli, M.; Montironi, R.; Kirkali, Z. (May 2006). "2004 WHO classification of the renal tumors of the adults.". Eur Urol 49 (5): 798-805. doi:10.1016/j.eururo.2005.11.035. PMID 16442207.
- ↑ Cangiano, T.; Liao, J.; Naitoh, J.; Dorey, F.; Figlin, R.; Belldegrun, A. (Feb 1999). "Sarcomatoid renal cell carcinoma: biologic behavior, prognosis, and response to combined surgical resection and immunotherapy.". J Clin Oncol 17 (2): 523-8. PMID 10080595.
- ↑ 5.0 5.1 Dall'Oglio, MF.; Lieberknecht, M.; Gouveia, V.; Sant'Anna, AC.; Leite, KR.; Srougi, M.. "Sarcomatoid differentiation in renal cell carcinoma: prognostic implications.". Int Braz J Urol 31 (1): 10-6. PMID 15763002.
- ↑ Chapman-Fredricks, JR.; Herrera, L.; Bracho, J.; Gomez-Fernandez, C.; Leveillee, R.; Rey, L.; Jorda, M. (Oct 2011). "Adult renal cell carcinoma with rhabdoid morphology represents a neoplastic dedifferentiation analogous to sarcomatoid carcinoma.". Ann Diagn Pathol 15 (5): 333-7. doi:10.1016/j.anndiagpath.2011.03.002. PMID 21665507.
- ↑ Golshayan, AR.; George, S.; Heng, DY.; Elson, P.; Wood, LS.; Mekhail, TM.; Garcia, JA.; Aydin, H. et al. (Jan 2009). "Metastatic sarcomatoid renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy.". J Clin Oncol 27 (2): 235-41. doi:10.1200/JCO.2008.18.0000. PMID 19064974.