Renal Cell Carcinoma, Unclassified with Medullary Phenotype and Synchronous Renal Clear Cell Carcinoma Present in a Patient with No Sickle Cell Trait/Disease: Diagnostic and Therapeutic Challenges

Anticancer Research
Jenny Z LaiDengfeng Cao

Abstract

Renal medullary carcinoma (RMC) is an aggressive high-grade renal cell carcinoma (RCC) associated almost exclusively with sickle cell trait or sickle cell disease. However, RCC with RMC features has rarely been reported in patients with no sickle cell trait or disease. Renal cell carcinoma unclassified with medullary phenotype (RCCU-MP) is a newly-coined term used by an international panel of experts to describe renal cell carcinoma showing morphologic and immunohistochemical features of renal medullary carcinoma in patients without sickle cell trait/disease. So far, only one study in the English literature has described five such cases. Here, we report a case with unique clinical and pathological features in a 76-year-old male patient without sickle cell trait. The patient had a history of colon cancer with liver and lung metastases and was found to have a new renal mass in his right kidney during the follow up. A right nephrectomy was performed and showed two separate masses (tumor 1 and tumor 2). Tumor 1 had histologic features of RMC and the tumor cells were positive for CK7, Pax8, and OCT4 and showed loss of nuclear INI1 expression. Tumor 1 was diagnosed as RCCU-MP (6.3 cm, pT3aNx, WHO/ISUP nuclear grade 3). Tumor 2 showed...Continue Reading

Citations

Jan 19, 2019·Current Urology Reports·Leandro BlasFederico Cicora
Oct 17, 2019·Pathology International·Sadatoshi TsuzukiHironori Haga
Mar 6, 2021·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Kiril TrpkovAnthony J Gill
Apr 13, 2021·Seminars in Diagnostic Pathology·Deepika SirohiMahul B Amin
Jan 7, 2021·Archives of Pathology & Laboratory Medicine·Nicholas BaniakMichelle S Hirsch

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