Sarcomatoid Renal Cell Carcinoma

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Sarcomatoid Renal Cell Carcinoma

Mahera Roohi*, Imrana Tanvir**, Sumera Qazi*
*Department of Pathology, Shalamar Medical and Dental College Lahore
**Department of Pathology, FMH College of Medicine and Dentistry Lahore
Abstract: Sarcomatoid renal cell carcinoma (SRCC) is an aggressive variant of renal cell carcinoma. It is thought
to originate predominantly from clear cell carcinoma through de-differentiation. It is a rare entity constituting about
1-5% of all renal malignant neoplasms and is more commonly associated with conventional (clear cell) renal cell
carcinomas. We report a case of 50 years old male who presented with complaints of haematuria and abdominal
pain. The biopsy confirmed sarcomatoid variant of renal cell carcinoma.
Key words: Sarcomatoid carcinoma, Renal cell carcinoma
Sarcomatoid renal cell carcinoma (SRCC) is currently defined in the 2004 World Health Organization (WHO)
classification of renal tumors as any histologic type of renal cell carcinoma (RCC) containing foci of highgrade malignant spindle cells.1 Most patients are symptomatic at diagnosis; abdominal pain and haematuria are commonly observed. Sarcomatoid tumors are characterized by a relatively high incidence of metastases to the lung and bone at
presentation.2 Positive immunohistochemical markers in these tumors include AE1/AE3, epithelial membrane antigen, and vimentin, which supports epithelial origin.3 Sarcomatoid carcinomas signify a poor prognosis.4 The prognostic implication of the proportion of sarcomatoid component within an RCC tumor is an area of controversy. A higher proportion of sarcomatoid differentiation has been associated with worse survival in some series.5
Case Report
A fifty year old male presented with the history of abdominal pain and haematuria. The ultrasound and CT scan showed a renal mass. Laparotomy was performed and the nephrectomy specimen was sent for histopathology.
GROSS EXAMINATION: The whole kidney was replaced by a necrotic mass measuring 19x18x10cm.
Renal parenchyma was identified at the periphery measuring 5cm.Tumor was invading peri-nephric fat
and Gerota’s fascia.


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