Chromophobe renal cell carcinoma with rhabdoid differentiation in an adult

Abstract

Cases of adult renal cell carcinoma with rhabdoid features have been reported in the literature, usually in association with conventional clear cell and papillary tumors. Till date, only one report described chromophobe renal cell carcinoma with rhabdoid differentiation. We report a case of a 47-year-old male patient that underwent a routine medical check-up. Computer tomography scan revealed a large heterogeneous mass in the left kidney, multiple nodular changes in the lungs and multiple enlarged lymph nodes. On microscopic examination of the left nephrectomy specimen, 65 % of the kidney tumor was comprised of rhabdoid foci and the rest of the tumor showed eosinophilic areas consistent with chromophobe renal cell carcinoma. Final diagnosis was chromophobe renal cell carcinoma with rhabdoid differentiation. Behavior of these tumors in adults is more aggressive, demands more aggressive treatment and has poor prognosis. Therefore, rhabdoid differentiation should be recognized in this type of carcinoma and mentioned in the pathohistology report.

Sarcomatoid and Rhabdoid Renal Cell Carcinoma

“…Different terminologies have been used to describe renal cell carcinoma with these rhabdoid cells. 1,6,8,[13][14][15][16][37][38][39]122,[128][129][130][135][136][137][138][139][140][141][142][143][144][145][146][147][148][149] In 1991 a report from the National Wilms' Tumor Study Pathology Center presented 6 cases of renal cell carcinoma and 2 collecting duct carcinomas as mimicking rhabdoid tumor of kidney. 6 Also in 1991, 3 cases of sarcomatoid renal cell carcinoma similar to rhabdoid tumor of kidney (1 case) 135 or of rhabdoid cell phenotype (2 cases) 136 were published.…”

“…Since that time the designation of renal cell carcinoma with rhabdoid features has been commonly utilized. Additional descriptors include focal rhabdoid/plasmacytoid appearance, 130 rhabdoid variant, 138 adult rhabdoid renal cell carcinoma, 52,139 rhabdoid differentiation, 9,13,14,16,[37][38][39]141,142 rhabdoid morphology, 128,129,140 rhabdoid phenotype, 143 rhabdoid variant histology, 122 rhabdoid component, 144,145 rhabdoid changes, 8 rhabdoid pattern, 146,147 and rhabdoid quality. 148 In 2004 the third edition of the WHO Classification of Tumors of the Urinary System and Male Genital Organs noted that renal medullary carcinomas can have sheets of cells with a rhabdoid quality.…”

“…Different terminologies have been used to describe renal cell carcinoma with these rhabdoid cells 1,6,8,13–16,37–39,122,128–130,135–149 . In 1991 a report from the National Wilms’ Tumor Study Pathology Center presented 6 cases of renal cell carcinoma and 2 collecting duct carcinomas as mimicking rhabdoid tumor of kidney 6 .…”