A Novel Prognostic Criteria and Targeted Therapy in Sarcomatoid Variant of Chromophobic Renal Cell Carcinoma
V. V. Ermilov
Volgograd State Medical, Russian Federation, Volgograd, St. Pavshikh Bortzov, Russia.
O. V. Dolzhanski
Federal Institution "Russian Scientific Center of Surgery Named After Acad. B. V. Petrovskogo", Russian Federation, 119991, Moscow, GSP-1, Abrikosovsky Lane, Russia.
A. Agarwal *
Department of Pathology, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia.
H. A. Mouhammed
Department of Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Chromophobic renal cell carcinoma (CRCC) is a rare subtype of renal cell carcinoma, accounting for only 5.9% of epithelial kidney tumors. This study reports the findings studied in chromophobic renal cell carcinoma case with sarcomatoid differentiation in a 66-year-old patient admitted in Federal State Budgetary Institution (FSBI). This study concludes that, the criteria of aggressive behavior for chromophobic renal cell carcinoma include the following characteristics: The size of the tumor more than 7.0 cm; presence of necrosis; grade III according to Paner et al. classification; sarcomatoid differentiation (more than 30.0%); positive reaction with common acute lymphocytic leukemia antigen (CD10); nuclear expression of p53 in more than 80.0% of tumor cells; proliferation marker Ki67 in more than 9.0% of tumor cells. In this case, the indication for targeted therapy was sarcomatoid differentiation (in more than 10.0% of the tumor) and a strong reaction with Vascular endothelial growth factor; 5-6 points ((VEGF-A).
Keywords: Sarcomatoid differentiation, renal cell carcinoma, epithelial kidney tumors, tumor cells.