Chromophobe Renal Cell Carcinoma with Sarcomatoid Differentiation (osteosarcomatous and chondrosarcomatous differentiation)—A Case Report and Comprehensive Review
Main Article Content
Keywords
chondrosarcomatous differentiation, chromophobe, osteosarcomatous differentiation, renal cell carcinoma
Abstract
Chromophobe renal cell carcinomas (ChRCCs) have a good prognosis and comprise approximately 5–7% of renal cell carcinomas (RCCs). The sarcomatoid differentiation in RCC is found in around 5–10% of cases; however, in ChRCC, it is much less than in other RCCs and poorly responds to chemotherapeutic agents. A study by de Peralta-Venturina et al. found 9% sarcomatoid differentiation in chromophobe RCC. We present the case of a 58-year-old female with a left abdominal mass diagnosed as ChRCC with the existence of sarcomatous differentiation including osteosarcomatous and chondrosarcomatous, which are of adverse prognosis. Osteosarcoma-like divergent differentiation in RCC is extremely rare, with limited documented cases. It should be carefully considered in evaluating and managing renal masses due to its potential impact on clinical outcomes.
References
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21. Joseph RW, Millis SZ, Carballido EM, Bryant D, Gatalica Z, Reddy S, Bryce AH, Vogelzang NJ, Stanton ML, Castle EP, et al. PD-1 and PD-L1 expression in renal cell carcinoma with sarcomatoid differentiation. Cancer Immunol Res. 2015;3(12): 1303–7. 10.1158/2326-6066.CIR-15-0150.
22. NCCN. National Comprehensive Cancer Network – Home [Internet]. [cited 2024 Jun 21]. Available from: https://www.nccn.org
23. Itoh T, Chikai K, Ota S, Nakagawa T, Takiyama A, Mouri G, et al. Chromophobe renal cell carcinoma with osteosarcoma-like differentiation. Am J Surg Pathol. 2002;26(10):1358–62. 10.1097/00000478-200210000-00013
2. WHO Classification of Tumours Editorial Board. Urinary and male genital tumors [Internet]. In: WHO Classification of Tumours series. 5th ed.; Vol. 8. Lyon (France): International Agency for Research on Cancer; 2024. Available from: https://tumourclassification.iarc.who.int/chapters/36.
3. Cindolo L, de la Taille A, Schips L, Zigeuner RE, Ficarra V, Tostain J, et al. Chromophobe renal cell carcinoma: Comprehensive analysis of 104 cases from multicenter European database. Urology. 2005;65(4):681–6. 10.1016/j.urology.2004.11.005
4. Nickerson ML, Warren MB, Toro JR, Matrosova V, Glenn G, Turner ML, et al. Mutations in a novel gene lead to kidney tumors, lung wall defects, and benign tumors of the hair follicle in patients with the Birt-Hogg-Dubé syndrome. Cancer Cell. 2002;2(2):157–64. 10.1016/s1535-6108(02)00104-6
5. Pavlovich CP, Walther MM, Eyler RA, Hewitt SM, Zbar B, Linehan WM, et al. Renal tumors in the Birt–Hogg–Dubé syndrome. Am J Surg Pathol. 2002;26(12):1542–52. 10.1097/00000478-200212000-00002
6. Abuorouq S, Sahawneh F, Halalsheh O, Haddad HK, Mekail R, Alzoubi H, et al. Chromophobe renal cell carcinoma with sarcomatoid and heterologous osteosarcoma-like differentiation: A case report and literature review. J Surg Case Rep. 2023;2023(8):rjad476. 10.1093/jscr/rjad476
7. Gira FA, Barbieri A, Fellegara G, Zompatori M, Corradi D. Dedifferentiated chromophobe renal cell carcinoma with massive osteosarcoma-like divergent differentiation: A singular entity in the spectrum of retroperitoneal calcifying tumors. Int J Surg Pathol. 2010;18(5):419–23. [cited 2024 Mar 16]. Available from: https://pubmed.ncbi.nlm.nih.gov/19098016/. 10.1177/1066896908329414
8. Dedifferentiated chromophobe renal cell carcinoma with massive osteosarcoma-like divergent differentiation: a singular entity in the spectrum of retroperitoneal calcifying tumors – PubMed [Internet]. [cited 2024 Mar 16]. Available from: https://pubmed.ncbi.nlm.nih.gov/19098016/
9. Hanif A, Pandey M, Khan S, Attwood K, George S. Metastatic sarcomatoid renal cell carcinoma treated with immune checkpoint inhibitors. Oncoimmunology. 2019;8(8):1606639. 10.1080/2162402X.2019.1606639
10. Raychaudhuri R, Riese MJ, Bylow K, Burfeind J, Mackinnon AC, Tolat PP, Iczkowski KA, Kilari D. Immune checkpoint inhibition in sarcomatoid renal cell carcinoma: A new treatment paradigm. Clin Genitourin Cancer. 2017;15(5):e897–901. 10.1016/j.clgc.2017.05.018.
11. de Peralta-Venturina M, Moch H, Amin M, Tamboli P, Hailemariam S, Mihatsch M, et al. Sarcomatoid differentiation in renal cell carcinoma: A study of 101 cases. Am J Surg Pathol. 2001;25(3):275–84.
12. Mouallem NE, Smith SC, Paul AK. Sarcomatoid renal cell carcinoma: Biology and treatment advances. Urol Oncol. 2018;36(6):265–71. 10.1016/j.urolonc.2017.12.012
13. Bi M, Zhao S, Said JW, Merino MJ, Adeniran AJ, Xie Z, et al. Genomic characterization of sarcomatoid transformation in clear cell renal cell carcinoma. Proc Natl Acad Sci U S A. 2016;113(8):2170–5. 10.1073/pnas.1525735113
14. Akhtar M, Tulbah A, Kardar AH, Ali MA. Sarcomatoid renal cell carcinoma: The chromophobe connection. Am J Surg Pathol. 1997;21(10):1188–95. 10.1097/00000478-199710000-00009
15. Tun HW, Marlow LA, von Roemeling CA, Cooper SJ, Kreinest P, Wu K, et al. Pathway signature and cellular differentiation in clear cell renal cell carcinoma. PLoS One. 2010;5(5):e10696. 10.1371/journal.pone.0010696
16. Jones TD, Eble JN, Wang M, Maclennan GT, Jain S, Cheng L. Clonal divergence and genetic heterogeneity in clear cell renal cell carcinomas with sarcomatoid transformation. Cancer. 2005;104(6):1195–203. 10.1002/cncr.21288
17. Wang Z, Kim TB, Peng B, Karam J, Creighton C, Joon A, et al. Sarcomatoid renal cell carcinoma has a distinct molecular pathogenesis, driver mutation profile, and transcriptional landscape. Clin Cancer Res. 2017;23(21):6686–96. 10.1158/1078-0432.CCR-17-1057
18. Hyodo T, Kanzawa M, Hara S, Takahashi K, Ogawa S, Furukawa J, et al. Chromophobe renal cell carcinoma with sarcomatoid differentiation containing various heterologous components. Pathol Int. 2018;68. 10.1111/pin.12704
19. Quiroga-Garza G, Khurana H, Shen S, Ayala AG, Ro JY. Sarcomatoid chromophobe renal cell carcinoma with heterologous sarcomatoid elements: A case report and review of the literature. Arch Pathol Lab Med. 2009;133(11):1857–60. 10.5858/133.11.1857
20. Hes O, Michal M, Kinkor Z, Tomes P, Zu°chová M, Nápravník I. Sarcomatous chromophobe cell renal carcinoma. 2 case reports. Cesk Patol. 1999;35(1):15–9. [cited 2024 Mar 22]. Available from: https://scholar.google.com/scholar_lookup?journal=Cesk+Patol&title=Sarcomatous+chromophobe+cell+renal+carcinoma:+2+case+reports&author=O+Hes&author=M+Michal&author=Z+Kinkor&volume=35&issue=1&publication_year=1999&pages=15-19&pmid=10379058&
21. Joseph RW, Millis SZ, Carballido EM, Bryant D, Gatalica Z, Reddy S, Bryce AH, Vogelzang NJ, Stanton ML, Castle EP, et al. PD-1 and PD-L1 expression in renal cell carcinoma with sarcomatoid differentiation. Cancer Immunol Res. 2015;3(12): 1303–7. 10.1158/2326-6066.CIR-15-0150.
22. NCCN. National Comprehensive Cancer Network – Home [Internet]. [cited 2024 Jun 21]. Available from: https://www.nccn.org
23. Itoh T, Chikai K, Ota S, Nakagawa T, Takiyama A, Mouri G, et al. Chromophobe renal cell carcinoma with osteosarcoma-like differentiation. Am J Surg Pathol. 2002;26(10):1358–62. 10.1097/00000478-200210000-00013
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Published
Sep 10, 2024
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Chromophobe Renal Cell Carcinoma with Sarcomatoid Differentiation (osteosarcomatous and chondrosarcomatous differentiation)—A Case Report and Comprehensive Review. (2024). Journal of Kidney Cancer, 11(3), 59-64. https://doi.org/10.15586/jkcvhl.v11i3.343
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Kidney Cancer: Case Reports
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How to Cite
Chromophobe Renal Cell Carcinoma with Sarcomatoid Differentiation (osteosarcomatous and chondrosarcomatous differentiation)—A Case Report and Comprehensive Review. (2024). Journal of Kidney Cancer, 11(3), 59-64. https://doi.org/10.15586/jkcvhl.v11i3.343