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Case Reports
. 2020 Winter;15(1):57-61.
doi: 10.30699/IJP.2019.109242.2147.

Sarcomatoid Chromophobe Renal Cell Carcinoma with Heterologous Component

Sushma Bharti  1 , Gautam Ram Choudhary  2 , Naresh Jyotsna Bharti  1 , Pawan Kumar Garg  3 , Arsha B S  1 , Poonam Abhay Elhence  1
Affiliations
Case Reports

Sarcomatoid Chromophobe Renal Cell Carcinoma with Heterologous Component

Sushma Bharti et al. Iran J Pathol. 2020 Winter.

Abstract

Clear cell renal cell carcinoma (RCC) is the most common malignant renal tumor in adults, while chromophobe RCC (CRCC) is the third most common. Any subtypes of RCC can undergo sarcomatoid differentiation, but heterologous differentiation in sarcomatoid area is very rare in RCC. Here a 61-year male is presented with hematuria and palpable mass. Clinicoradiologically, RCC was considered and left radical nephrectomy was performed. A well-circumscribed renal mass located in the upper pole of the left kidney with variegation and extensive areas of bony hard calcification noted, was reported as CRCC with sarcomatoid differentiation containing heterologous component. CRCC subtype has good prognosis but show dismal prognosis when associated with sarcomatous differentiation. We found 11 cases of sarcomatoid CRCC containing heterologous elements reported in indexed English literature. CRCC must be differentiated from Conventional RCC and Oncocytoma. The extensive sampling of the tumor is needed. We report a very rare case of CRCC with sarcomatoid differentiation containing heterologous elements.

Keywords: Cell differentiation; Chromophobe; Kidney neoplasms; Renal cell carcinoma; Sarcomatoid.

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Conflict of interest statement

The authors declared that there is no conflict of interest regarding the publication of this article.

Figures

Fig. 1
Fig. 1
CECT abdomen, axial (a, b) and coronal (c) images showing heterogeneously enhancing mass (asterix) at upper pole of left kidney with calcification and necrosis. Enlarged lymph nodes in left para-aortic area (black arrow)
Fig. 2
Fig. 2
CECT abdomen (a) showing single left renal artery (black arrow) and (b, c) images showing duplication of IVC on both side of aorta. Left renal vein draining into left side IVC (white arrow)
Fig. 3
Fig. 3
Upper pole of kidney shows grey white to grey brown mass (a) Extensive bony hard calcification seen (b)
Fig. 4
Fig. 4
Epithelial and spindle-shaped tumor cells (H&E, 10x a) perineural invasion (H&E, 20x b) epithelial tumor cells with centrally placed nuclei and perinuclear halo (HE 40x c), entrapped glomeruli in sarcomatoid tumor cells (H&E, 40x d)
Fig. 5
Fig. 5
Tumor deposits in perinephric fat (H&E, 10x a) osteosarcoma component (H&E, 40x) b) CK 7 immunoreactivity in epithelial tumor cells and unremarkable tubules of normal kidney, spindle cells are negative (H&E, 10x c). E- Cadherin immunoreactivity in epithelial tumor cells (H&E, 20x d).
See this image and copyright information in PMC

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