Renal cell carcinoma with sarcomatoid differentiation

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Sarcomatoid differentiation in a chromophobe renal cell carcinoma. H&E stain.

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]
    • It is considered an indicator of progression.
    • Previously considered a distinct entity.[1][3][4]
  • Tend to present at higher stage.
  • Worse prognosis when adjusted for stage.
  • ISUP nucleolar grade (Fuhrman grade) 4 by definition.

Microscopic

Features:[2]

  1. Renal cell carcinoma.
  2. Sarcomatoid component:

Notes:

DDx:

Images

Case 1

Case 2

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See also

References

  1. 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. 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. 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.
  4. 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. 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.
  6. 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.
  7. 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.