Sarcomatoid renal cell carcinoma

Q: 44 years old male is admitted to the ICU after partial Renal Cell Carcinoma (RCC) removal, as some parts were found to be unresectable perioperatively. Patient is designated as having RCC with Sarcomatoid features. It is considered a good sign with a good prognosis for chemotherapy later.

A) True

B) False

Answer: B

Sarcomatoid dedifferentiation in RCC (clear or non-clear) consists of cell components that are spindled or resemble sarcoma cells. These tumors are recognized for their distinctive molecular and biological characteristics, including their clinical response to therapies.

The prognosis of patients with advanced, unresectable, or metastatic sarcomatoid RCC is usually poor. There is hope that with the arrival of checkpoint inhibitor immunotherapy, prognosis may improve, as newly emerging data show some evidence of a good response.

#oncology

#surgical-critical-care

References:

1. Delahunt B, Cheville JC, Martignoni G, et al. The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters. Am J Surg Pathol 2013; 37:1490.

2. Fontes-Sousa M, Calvo E. First-line immune checkpoint inhibitors in advanced or metastatic renal cell carcinoma with sarcomatoid features. Cancer Treat Rev. 2022 Apr;105:102374. doi: 10.1016/j.ctrv.2022.102374. Epub 2022 Mar 10. PMID: 35303549.

3. Su H, Yu C, Ma X, Yu X, Sun G. Immunotherapy treatment for sarcomatoid renal cell carcinoma: case report and literature review. Ann Med Surg (Lond). 2024 Feb 28;86(9):5471-5475. doi: 10.1097/MS9.0000000000001647. PMID: 39239004; PMCID: PMC11374251.