Feline sarcomatoid renal cell carcinoma with peritoneal carcinomatosis and effusion

A 9-y-old, castrated male, domestic medium-hair cat diagnosed previously with chronic kidney disease developed anorexia and vomiting. Ultrasonography revealed abdominal effusion and a left renal perihilar mass. Cytologic evaluation of the peritoneal fluid and mass identified atypical epithelioid cells suspected to be of renal epithelial or possible mesothelial origin. Immunohistochemical (IHC) evaluation of a formalin-fixed, paraffin-embedded peritoneal fluid cell block indicated both pancytokeratin and vimentin expression in the atypical epithelioid cell population. With scanning electron microscopic evaluation, similar epithelioid cells lacked the cell-surface microvilli expected of mesothelium, supporting an antemortem diagnosis of probable carcinoma. On postmortem examination, the left kidney was effaced by an infiltrative neoplasm with myriad similar nodules throughout the peritoneum. The neoplasm was composed primarily of polygonal-to-spindle-shaped cells with strong vimentin and weak pancytokeratin cytoplasmic immunolabeling. Further IHC characterization with PAX8, CK18, KIT, napsin A, SMA, desmin, CD18, and claudin 5 was performed. Histologic and IHC findings supported a diagnosis of sarcomatoid renal cell carcinoma with peritoneal carcinomatosis. An in vitro cell culture line of neoplastic cells harvested from the primary tumor was successfully established for future research endeavors.

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Salvage ipilimumab associated with a significant response in sarcomatoid renal cell carcinoma

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-000584 ◽

2020 ◽

Vol 8 (1) ◽

pp. e000584 ◽

Cited By ~ 1

Author(s):

Gemlyn George ◽

Laura Schmidt ◽

Parag Tolat ◽

Mathew Riese ◽

Deepak Kilari

Keyword(s):

Renal Cell Carcinoma ◽

Partial Response ◽

Combination Therapy ◽

Cell Carcinoma ◽

Renal Cell ◽

Left Kidney ◽

Single Agent ◽

Flank Pain ◽

Significant Response ◽

Sarcomatoid Renal Cell Carcinoma

BackgroundMetastatic sarcomatoid renal cell carcinoma (sRCC) is an aggressive variant of RCC with generally poor prognosis. Treatment with vascular endothelial growth factor inhibitors or chemotherapy generates only short-lived responses. Recent research has suggested a role for combination checkpoint inhibition as first line treatment for metastatic sRCC. This therapy consists of induction with cytotoxic T-lymphocyte-associated protein 4 inhibitor, ipilimumab, administered with programmed cell death protein 1 (PD-1) inhibitor, nivolumab. After completion of four cycles of combination therapy, single-agent maintenance nivolumab is recommended until progression. Patients who progress on maintenance nivolumab are switched to alternate therapy. Herein, we present a case of a patient with RCC who progressed on maintenance nivolumab who, on retreatment with ipilimumab, demonstrated a significant response In addition, we summarize important findings to support the role of salvage ipilimumab in patients with sRCC.Case presentationA 46-year-old man presented with flank pain and hematuria, the work up of which noted a left kidney mass for which he underwent nephrectomy and was diagnosed with localized sRCC with 60% sarcomatoid differentiation. Within 3 months of nephrectomy, he presented with recurrent flank pain and was diagnosed with recurrence of disease. He was treated with ipilimumab 1 mg/kg and nivolumab 3 mg/kg for four doses and demonstrated a partial response. He was then transitioned to single agent nivolumab maintenance. After 3 months on maintenance therapy, he was noted to have progression of disease. Given prior response to immune check point combination, it was decided to rechallenge the patient with 1 mg/kg ipilimumab. After two doses of ipilimumab and nivolumab combination therapy, the patient was noted to have a partial response. He maintained a response for an additional 9 months and treatment was eventually discontinued due to grade 3 toxicity and progression.ConclusionsThis case report demonstrates the utility of retreatment with ipilimumab as a salvage option for patients progressing on maintenance PD-1 inhibitors in metastatic RCC. Further studies are needed to identify predictors of response and toxicity to this approach, as well as the optimal scheduling of ipilimumab with maintenance nivolumab.

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Renal epithelioid angiomyolipoma mimicking urothelial carcinoma of the upper urinary tract

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2014.3.235 ◽

2014 ◽

Vol 86 (3) ◽

pp. 235 ◽

Cited By ~ 1

Author(s):

Senol Adanur ◽

Ercüment Keskin ◽

Tevfik Ziypak ◽

Erdem Koc ◽

Elif Demirci ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Urinary Tract ◽

Cell Carcinoma ◽

Renal Cell ◽

Renal Carcinoma ◽

Left Kidney ◽

Upper Urinary Tract ◽

Urothelial Cell Carcinoma ◽

Epithelioid Angiomyolipoma ◽

Sarcomatoid Renal Cell Carcinoma

Epithelioid angiomyolipoma is a rare mesenchymal tumor arising mainly in the kidney that can potentially behave aggressively. Epithelioid angiomyolipoma can often resemble sarcomatoid renal cell carcinoma, high grade renal carcinoma or sarcoma. Its similarity to renal cell carcinoma has been emphasized in most of the cases reported in literature. With the purpose of contributing to the awareness of this similarity, a 32-year-old female patient with renal epitelioid angiomyolipoma in the left kidney which radiologically mimicked urothelial cell carcinoma of the upper urinary tract is presented.

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Renal cell carcinoma with peritoneal carcinomatosis in a mare

Ciência Rural ◽

10.1590/0103-8478cr20160485 ◽

2017 ◽

Vol 47 (1) ◽

Author(s):

Leonardo Pereira Mesquita ◽

Francisco Duque de Mesquita Neto ◽

Mary Suzan Varaschin ◽

Angélica Terezinha Barth Wouters ◽

Flademir Wouters

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Peritoneal Carcinomatosis ◽

Peritoneal Cavity ◽

Renal Cell ◽

Left Kidney ◽

Cystic Mass ◽

Left Flank ◽

Pattern Diagnosis ◽

Extensive Involvement

ABSTRACT: Renal cell carcinoma, especially with extensive involvement of peritoneal cavity, is rarely described in horses. This study described a case of renal cell carcinoma in an 8-year-old mare, which presented with an enlargement in the left flank, decreased appetite and straining to defecate. Clinically, a tumor in the left retroperitoneal space was detected by rectal examination and ultrasonography. The animal died after one month of clinical evolution. At necropsy, the left kidney was completely effaced by a 50cm in diameter, irregular, round, lobulated cystic mass with necro-hemorrhagic areas. Within the peritoneal cavity, there was severe hemoperitoneum and numerous sessile and pedunculated masses ranging from 2.0 to 15.0cm diameter that were attached to the visceral and parietal peritoneum. Histologically, the primary neoplasia and its metastasis were composed by a proliferation of epithelial cells, which were arranged in a tubulopapillary pattern. Diagnosis of renal cell carcinoma with peritoneal carcinomatosis and hemoperitoneum was based on macroscopic aspects, and mainly on the histological features.

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Sarcomatoid Renal Cell Carcinoma: The Present and Future of Treatment Paradigms

Kidney Cancer ◽

10.3233/kca-210126 ◽

2021 ◽

pp. 1-13

Author(s):

Nellowe Candelario ◽

Christopher Geiger ◽

Thomas Flaig

Keyword(s):

Renal Cell Carcinoma ◽

Clinical Trials ◽

Targeted Therapy ◽

Cell Carcinoma ◽

Renal Cell ◽

Checkpoint Inhibitors ◽

Poor Response ◽

Future Research ◽

Sarcomatoid Renal Cell Carcinoma ◽

Post Hoc

Sarcomatoid renal cell carcinoma (sRCC) is an aggressive form of kidney cancer that is associated with poor prognosis. It can arise from any histologic type of renal cell carcinoma. The majority of cases will present with advanced or metastatic disease requiring systemic therapy. Nephrectomy is the treatment of choice in locally resectable disease. The therapeutic options for sRCC have evolved in the past decade. Cytotoxic chemotherapy and monotherapy with targeted therapy (VEGF and mTOR) have historically shown poor response rates and survival in the treatment of metastatic sRCC. The use of checkpoint inhibitors and their combination with targeted therapy against VEGF has changed the landscape and outcomes for renal cell carcinoma. Given the rarity of sRCC most of the data on treatment is from small cohorts or extrapolation from larger clinical trials. The benefit from the combination of checkpoint inhibitors and targeted therapy to VEGF has shown promise in the sRCC population in post hoc analysis of large clinical trials. Future research focusing on further characterizing the unique biologic and clinical features of sRCC is critical in advancing the knowledge and developing effective therapy to improve clinical outcomes and survival.

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Long stabilization of sarcomatoid renal cell carcinoma treated with sorafenib

Actas Urológicas Españolas (English Edition) ◽

10.1016/j.acuroe.2011.10.002 ◽

2012 ◽

Vol 36 (6) ◽

pp. 385-386

Author(s):

M.J. Juan ◽

M.Á. Climent

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Sarcomatoid Renal Cell Carcinoma

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Sarcomatoid renal cell carcinoma with foci of chromophobe carcinoma

Pathology & Oncology Research ◽

10.1007/bf03033725 ◽

2002 ◽

Vol 8 (2) ◽

pp. 142-144 ◽

Cited By ~ 4

Author(s):

Gábor Cserni ◽

Rita Beáta Kovács ◽

Miklós Tarján ◽

Zoltán Sápi ◽

Zsolt Domján ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Sarcomatoid Renal Cell Carcinoma

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Sarcomatoid Renal Cell Carcinoma of Papillary Origin

Archives of Pathology & Laboratory Medicine ◽

10.5858/2000-124-1830-srccop ◽

2000 ◽

Vol 124 (12) ◽

pp. 1830-1832 ◽

Cited By ~ 2

Author(s):

Ronald J. Cohen ◽

John E. McNeal ◽

Marleen Susman ◽

Loryn N. Sellner ◽

Barry J. Iacopetta ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Conclusive Evidence ◽

Clear Cell Tumor ◽

Multiple Copies ◽

Sarcomatoid Renal Cell Carcinoma ◽

Trisomy 7

Abstract Sarcomatoid renal cell carcinoma (SRCC) is an aggressive tumor variant thought to arise predominantly from dedifferentiation of clear cell carcinoma. A few reports of SRCC associated with non–clear cell tumors led to the presumption that SRCC may arise from any renal cell carcinoma, although direct evidence of this is lacking. Cytogenetic studies on 3 previously documented SRCCs associated with papillary renal cancers showed either 3p deletions or absence of trisomy 7, 17 in the sarcomatoid tumors, suggesting origin from a coexistent clear cell tumor. The present case represents the first conclusive evidence of direct progression of non–clear cell carcinoma to SRCC with both tumor components containing multiple copies of chromosomes 7 and 17. Many genetic anomalies, including p53 mutations, frequently recognized in SRCC were not recognized in this case, highlighting the importance of cytogenetic evaluation of all SRCC. The patient is well and without evidence of tumor progression 1 year after surgery, and the sinister outlook of SRCC in association with clear cell carcinoma may not apply in SRCC of non–clear cell origin.

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Summary of the first annual Genitourinary Medical Oncology Conference Renal Cell Carcinoma Forum

Canadian Urological Association Journal ◽

10.5489/cuaj.62 ◽

2012 ◽

Vol 1 (2S) ◽

Author(s):

Lori A. Wood ◽

Bernard Escudier ◽

Neil Reaume

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Metastatic Renal Cell Carcinoma ◽

Renal Cell ◽

Medical Oncology ◽

Practical Experience ◽

Sarcomatoid Renal Cell Carcinoma

The first annual Canadian Genitourinary Medical Oncology Conference washeld in June 2006 before the Canadian Urology Association Annual Meeting.This article summarizes 3 presentations that took place as part of the Renal CellCarcinoma Forum: “Treatment of Metastatic Renal Cell Carcinoma: 2006 andBeyond” was presented by Dr. Bernard Escudier; “Practical Experience withTargeted Therapy,” by Dr. Lori Wood; and “Sarcomatoid Renal Cell Carcinoma,”by Dr. Neil Reaume.

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