MDM2-positive papillary sarcomatoid renal cell carcinoma: a potential diagnostic pitfall

Virchows Arch. 2020 May;476(5):783-786. doi: 10.1007/s00428-019-02703-9. Epub 2019 Nov 16.

Abstract

Sarcomatoid renal cell carcinoma is a highly aggressive form of carcinoma, histologically showing both carcinomatous and mesenchymal component in different proportions. We present a case of advanced type 1 papillary sarcomatoid renal cell carcinoma infiltrating adjacent organs and showing positivity for MDM2 by immunohistochemistry and MDM2 amplification by fluorescence in situ hybridization. This finding, together with sarcomatoid morphology, poses a potential pitfall for diagnosis with dedifferentiated liposarcoma. MDM2 is known to be altered in various human sarcomas. Only recently, MDM2 alterations have been reported in carcinomas. The presented case illustrates the need of thorough sampling with clinic-pathological correlation before making a final diagnosis in sarcomatoid retroperitoneal tumours. Additionally, the potential clinical implications of MDM2 amplification in renal cell carcinoma are discussed.

Keywords: FISH; Liposarcoma; MDM2; Renal cell carcinoma; Sarcomatoid change.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoma, Renal Cell / diagnosis*
  • Carcinoma, Renal Cell / genetics
  • Carcinoma, Renal Cell / pathology
  • Humans
  • Immunohistochemistry
  • Liposarcoma / diagnosis*
  • Liposarcoma / genetics
  • Liposarcoma / pathology
  • Male
  • Proto-Oncogene Proteins c-mdm2 / genetics*
  • Proto-Oncogene Proteins c-mdm2 / metabolism
  • Retroperitoneal Neoplasms / diagnosis*
  • Retroperitoneal Neoplasms / genetics
  • Retroperitoneal Neoplasms / pathology
  • Sarcoma / diagnosis*
  • Sarcoma / genetics
  • Sarcoma / pathology

Substances

  • MDM2 protein, human
  • Proto-Oncogene Proteins c-mdm2