Renal Cell Carcinoma Associated With Prominent Angioleiomyoma-like Proliferation

Abstract

Five cases of renal cell carcinoma of clear cell type are presented, Fuhrmann's grade 2, associated with a peculiar stromal proliferation having angioleiomyoma-like features. This proliferation was particularly prominent at the interphase between the tumor edge and the surrounding normal tissues, in which it acquired the configuration of a tumor capsule. Four similar cases were taken from the literature. We postulate that this angioleiomyoma-like change is a tumor epiphenomenon and that it represents yet another manifestation of the well-documented capacity of renal cell carcinoma to induce vascular proliferation, probably through the secretion of angiogenic and other growth factors by the tumor cells.

Uncommon and recently described renal carcinomas

“…113 Four similar cases had been previously reported in which angioleiomyoma-like stroma was admixed with clear cells that were interpreted as being either renal cell carcinoma or benign. [114][115][116][117] Since the publication of the original series two further reports have detailed the features of a further six cases.…”

Clear cell papillary renal cell carcinoma: differential diagnosis and extended immunohistochemical profile

“…21,22 As another point of differentiation, losses of chromosome 3 and 3p have been demonstrated in at least a subset of these tumors. 22 Michal et al 23 similarly reported the 'renal angiomyoadenomatous tumor,' which has subsequently been studied by other authors.…”

Renal cell carcinoma with angioleiomyoma-like stroma: clinicopathological, immunohistochemical, and molecular features supporting classification as a distinct entity

“…[1][2][3][4] However, the relationship of these tumors to other renal epithelial neoplasms, particularly clear cell renal cell carcinoma 4 and clear cell papillary renal cell carcinoma, 5-11 is incompletely understood. 13 To shed light on these relationships, in this study we assessed clinicopathological, immunohistochemical, and molecular features of renal epithelial neoplasms with a prominent stromal smooth muscle component.…”

“…Within the kidney, this proliferation also commonly entrapped non-neoplastic renal elements. 2 In some cases, entrapped non-neoplastic tubules became dilated, resembling cystic nephroma or mixed epithelial and stromal tumor. A prominent smooth muscle-like component was uniformly present as the basis for inclusion in this study; however, other areas of the stroma were edematous or hyalinized.…”