Sarcomas and sarcomatoid and mixed malignant tumors of the kidney in adults—part I

Farrow, George M.; Harrison, Edgar G.; Utz, David C.; ReMine, William H.

doi:10.1002/1097-0142(196809)22:3<545::aid-cncr2820220308>3.0.co;2-4

Cited by 150 publications

(63 citation statements)

References 15 publications

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“…Tumor and nodal classifications were attributed according to the 2002 AJCC TNM classification system [11]. sRCC was characterized by pleomorphic spindle cells and/or giant cells reminiscent of sarcoma, along with epithelial cells that typify RCC [2, 12]. Tumor size and the presence of positive surgical margins were documented.…”

Section: Methodsmentioning

confidence: 99%

Histologic subtype impacts cancer-specific survival in patients with sarcomatoid-variant renal cell carcinoma treated surgically

et al. 2015

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Purpose To report survival outcomes of patients treated surgically for sarcomatoid-variant renal cell carcinomas (sRCC) and to assess whether the underlying histologic subtype is an independent predictor of outcome. Methods One hundred and fifty-one patients underwent surgery at a referral center between 1991 and 2014 and had sRCC in final pathology. Kaplan–Meier curves for metastasis-free survival and cancer-specific survival (CSS) were calculated, and the log-rank test assessed differences between clear cell sRCC and nonclear cell sRCC. Cox regression models were generated to test the prognostic value of histologic subtype. Results Of 151 patients, 120 (79 %) had clear cell sRCC and 31 (21 %) had nonclear cell sRCC. Ninety-eight (65 %) patients had M0/Mx disease at presentation. Among those M0/Mx patients, metastasis-free survival probabilities were 49 % at 2 years [95 % confidence interval (CI) 38–60] and 39 % at 5 years (95 % CI 28–50), while CSS probabilities were 50 % at 2 years (95 % CI 41–58) and 32 % at 5 years (95 % CI 24–41). There was no significant difference in metastasis-free survival between clear cell and nonclear cell sRCC (p = 0.8). However, patients with nonclear cell sRCC had significantly lower CSS than patients with clear cell sRCC (p = 0.035). In multivariable analyses, nonclear cell sRCC conferred a higher risk of cancer-specific death compared with clear cell sRCC (HR 2.30, 95 % CI 1.38–3.82, p = 0.001). Conclusions In a cohort of patients treated surgically, the underlying histologic subtype of sRCC had an impact on CSS. These results present valuable information for individual counseling and patient selection in clinical trials.

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Section: Methodsmentioning

confidence: 99%

Histologic subtype impacts cancer-specific survival in patients with sarcomatoid-variant renal cell carcinoma treated surgically

et al. 2015

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“…Primary sarcomas of the kidney make up 1-3% of renal tumors (4,5). Primary renal malignant fibrous histiocytoma originating from the renal parenchyma or capsule makes up less than 6% of renal sarcomas (5,6,7).…”

Section: Dıscussıonmentioning

confidence: 99%

Primary malignant fibrous histiocytoma of the kidney: report of a case

Türk¹,

Kelten²,

Ozdemir³

et al. 2010

TJPATH

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Primary renal malignant fibrous histiocytoma is extremely rare. The prognosis is generally poor because of the high rate of local recurrence even if radical surgery is performed. We report a case of primary renal malignant fibrous histiocytoma in a 43-year-old woman. A well-defined renal mass (10x9x7cm) with lobulated contour was revealed by abdominal ultrasonography and computerized tomography in our patient who presented with left-flank pain. The contralateral kidney and renal functions were normal. No other primary tumor focus was detected by screening performed to exclude a metastasis to the kidney. However, a nodule consistent with metastasis was identified in the liver. The patient underwent left radical nephrectomy. A huge, yellowish-white, partly necrotic neoplasm infiltrating the renal parenchyma, perirenal fat and adrenal tissue was revealed by gross examination. Microscopically, the tumor was composed of pleomorphic spindle to polygonal cells arranged in fascicles and storiform structures with extensive necrosis. Twelve mitotic figures were noted in 10 high power fields. Immunohistochemical staining for vimentin and CD68 were positive whereas pan-cytokeratin, smooth muscle actin, S-100, HMB-45 and desmin were negative. "A pleomorphic type of malignant fibrous histiocytoma" was diagnosed based on both the microscopic and immunohistochemical findings. The patient presented with multiple bilateral lung metastasis three years after nephrectomy. Histopathological examination is essential since malignant fibrous histiocytoma cannot be differentiated clinically and radiologically from other lesions with kidney involvement. The overall prognosis is unfavorable with a recurrence rate of more than 50% and the 5-year-survival rate is only 14%.

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“…In 1968, it was proposed that the sarcoma-like histology represented transformation of malignant epithelial cells 5. Later chromosomal and genetic studies confirmed epithelial and sarcomatoid components are clonal but with extensive genetic diversity 6 7.…”

Section: Discussionmentioning

confidence: 99%

Extensive peritoneal carcinomatosis secondary to renal cell carcinoma with sarcomatoid and rhabdoid differentiation

et al. 2013

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Renal cell carcinoma (RCC), the most common malignancy of kidney, originates from renal tubular epithelium. It is subclassified based on histological and molecular features. Rarely, RCC can show focal to extensive sarcomatoid or rhabdoid differentiation. RCC with extensive sarcomatoid differentiation and no identifiable epithelial component is designated as unclassified RCC with sarcomatoid differentiation. Presence of sarcomatoid or rhabdoid differentiation is associated with poor prognosis. We describe autopsy findings in a case of RCC with extensive sarcomatoid and focal rhabdoid differentiation presenting with malignant ascites secondary to peritoneal carcinomatosis and multiorgan metastasis.

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Sarcomas and sarcomatoid and mixed malignant tumors of the kidney in adults—part I

Cited by 150 publications

References 15 publications

Histologic subtype impacts cancer-specific survival in patients with sarcomatoid-variant renal cell carcinoma treated surgically

Histologic subtype impacts cancer-specific survival in patients with sarcomatoid-variant renal cell carcinoma treated surgically

Primary malignant fibrous histiocytoma of the kidney: report of a case

Extensive peritoneal carcinomatosis secondary to renal cell carcinoma with sarcomatoid and rhabdoid differentiation

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