Kidney tumor - adult malignancies - Metanephric / mesonephric adenosarcoma

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Kidney tumor - adult malignancies

Other neoplasms – adult or adult/child

Metanephric / mesonephric adenosarcoma

Reviewers: Sean Williamson, M.D. (see Reviewers page)
Revised: 4 July 2012, last major update July 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Very rare tumors with sarcomatous stroma and benign epithelium

Case reports
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● Initial case described had rhabdomyoblastic differentiation (Am J Surg Pathol 1985;9:610)
● 21 year old woman with metanephric adenoma mixed with a malignant spindle cell component (Am J Surg Pathol 2001;25:1451)
● 56 year old woman (Pathol Int 2011;61:313)

Micro description
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● Separate but contiguous or intimately mingled epithelial and stromal components
● Epithelium: small cuboidal cells with scant cytoplasm, forming papillary projections, tubules, acini, solid-appearing areas, psammoma bodies, glomeruloid papillae (absence of necrosis/mitotic figures)
● Stroma: spindle cell proliferation with high mitotic rate and necrosis

Positive stains
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● Cytokeratin (AE1/AE3), vimentin

Negative stains
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● EMA, NSE

Differential diagnosis
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● Metanephric adenofibroma: stroma composed of benign fibroblast-like cells without significant atypia, increased mitotic rate or necrosis
● Mesoblastic nephroma: smooth muscle differentiation in stromal component
● Papillary renal cell carcinoma (with sarcomatoid component): cytokeratin 7 and EMA frequently positive, transition areas frequently present, chromosome 7 and 17 abnormalities

End of Kidney tumor - adult malignancies > Adult renal cell carcinoma > Metanephric / mesonephric adenosarcoma

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