The Chromophobe Renal Cell Carcinoma with Sarcomatoid Differentiaiton

Abstract

We present a rare case of a 52-year-old woman with a chromofobe renal cell carcinoma that had sarcomatoid components. The tumor, 70x60mm in size, was incidentally found by abdominal ultrasonography. An abdominal computed tomography demonstrated a well-demarcated solid tumor arising from the upper pole of the right kidney. Histologically, the tumor was composed of two intermixed distinct morphologic components: a chromophobe renal cell carcinoma and a high-grade spindle cell sarcoma. There was a sarcomatoid area composed of highly atypical spindle cells intermingled with rhabdoid cells. A unique histological finding of this tumor was the presence of calcification and psammoma body formation throughout the tumor. We think that this case supports the existence of a tumor progression pathway from chromofob to sarcomatoid renal cell carcinoma. A literature review on sarcomatoid chromofobe renal cell carcinoma with calcification was performed

Keywords

• Chromophobe renal cell carcinoma, sarcomatoid renal carcinoma, calcification

The Chromophobe Renal Cell Carcinoma with Sarcomatoid Differentiaiton

Abstract

52 yaşındaki bir kadında sarkomatöz komponentlere sahip kromofob renal hücreli kanserli nadir bir olgu sunmaktayız. Tümör, 70x60mm boyutunda, abdominal ultrasonla rastlantısal olarak bulundu. Abdominal bilgisayarlı tomografi sağ böbrek üst polden kaynaklanan sınırları belirgin solid bir tümör gösterdi. Histolojik olarak, tümör birbirine geçmiş iki farklı morfolojik komponentten ibaretti: kromofob renal hücreli kanser ve yüksek grade'li iğsi hücreli sarkom. Rabdoid hücrelerle karışmış oldukça atipik iğsi hücrelerden ibaret sarkomatoid bölge vardı. Bu tümörün eşsiz histolojik bulgusu kalsifikasyonun varlığı ve tümör boyunca psammoma yapı oluşumuydu. Bu olgunun kromofob renal hücreli karsinomdan sarkomatöz renal hücreli kansere bir tümör progresyon yolunun varlığını desteklediğini düşünmekteyiz. Kalsifikasyonlu sarkomatöz kromofob renal hücreli kanser üzerine literatür gözden geçirildi

Keywords

• Kromofob renal hücreli karsinom, sarkomatoid renal karsinom, kalsifikasyon

References

1. DeLong W, Grignon DJ, Eberwein P, Shum DT, Wyatt JK. Sarcomatoid renal cell carcinoma. An immunohistochemi- cal study of 18 cases. Arch Pathol Lab Med 1993; 117: 636-40.
2. 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 2005; 31(1):10-6.
3. Ro JY, Ayala AG, Sella A, Samuels ML, Swanson DA. Sarcomatoid renal cell carcinoma: clinicopathologic. A study of 42 cases. Cancer 1987; 59: 516-26.
4. Chakrabarti I, Giri A, Majumdar K, Anuradha DE. Sarcomatoid chromophobe renal cell carcinoma: Cytohistopathological correlation of a case. J Cytol 2010; 27(1):29-31.
5. De Peralta-Venturina M, Moch H, Amin M, et al. Sarcomatoid differentiation in renal cell carcinoma: a study of 101 cases. Am J Surg Pathol 2001; 25: 275-84.
6. Mian BM, Bhadkamkar N, Slaton JW, Pisters PW, et al. Prognostic factors and survival of patients with sarcoma- toid renal cell carcinoma. J Urol 2002; 167: 65-70.
7. Gomez-Roman JJ, Mayorga-Fernandez M, Fernandez- 17
8. Kuroda N, Hayashi Y, Itoh H. A case of chromofob renal cell carcinoma with sarcomatoid foci and a small daugh- ter lesion. Pathol Int 1998; 48: 812-7.

9. Mai KT, Veinot JP, Collins JP. Sarcomatous transformation of chromophobe cell renal carcinoma. Histopathology 1999; 34: 557-9.
10. Nagashima Y, Okudela K, Osawa A, et al. Chromophobe renal cell carcinoma with sarcomatoid change. A case re- port. Pathol Res Pract 2000;1 96: 647-52.
11. Abrahams NA, Ayala AG, Czerniak B. Chromophobe renal cell carcinoma with sarcomatoid transformation. Ann Diagn Pathol 2003; 7: 296-9.