Kidney tumor
Renal pelvis: Urothelial carcinoma and variants
Urothelial carcinoma of renal pelvis - sarcomatoid variant


Topic Completed: 1 October 2015

Revised: 18 September 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Urothelial carcinoma Sarcomatoid renal pelvis

Related Topics: Urothelial carcinoma of renal pelvis

Nicole K. Andeen, M.D.
Maria Tretiakova, M.D., Ph.D.
Page views in 2018: 340
Page views in 2019 to date: 186
Cite this page: Andeen NK, Tretiakova M. Urothelial carcinoma of renal pelvis - Sarcomatoid variant. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/kidneytumormalignanturothelialcarcinomasubtypessarcomatoid.html. Accessed September 22nd, 2019.
Definition / general
  • Biphasic malignant neoplasm with morphological or immunohistochemical evidence of carcinomatous and sarcomatous differentiation (WHO 2004)
Terminology
  • The terms carcinosarcoma, metaplastic carcinoma and malignant mixed tumor have been used interchangeably but can lead to confusion
  • WHO recommends the term "sarcomatoid variant of urothelial carcinoma" for these biphasic malignant neoplasms (WHO 2004)
Epidemiology
Sites
  • Kidney pelvis, proximal ureter
Etiology
  • Probably has a common malignant clonal origin, with epithelial and mesenchymal differentiation (J Pathol 2007;211:420)
Clinical features
  • Gross hematuria, flank pain, an abdominal mass and hydronephrosis
  • Similar to those of conventional urothelial tumors
Radiology images

Images hosted on other servers:
Missing Image

Mass in the left renal pelvis

Prognostic factors
Case reports
Treatment
  • No consensus on best treatment
  • Some treated with chemotherapy and radiation
Gross images

Contributed by Nicole K. Andeen, M.D. and Maria Tretiakova, M.D., Ph.D.

Sarcomatoid



Images hosted on other servers:
Missing Image

Solid white tumor

Microscopic (histologic) description
  • Sarcomatoid areas admixed with high grade urothelial carcinoma
  • Spindle cell component may account for 10% to > 60% of tumor
  • Epithelial component has urothelial differentiation or less commonly squamous or glandular differentiation
Microscopic (histologic) images

Contributed by Nicole K. Andeen, M.D. and Maria Tretiakova, M.D., Ph.D.

Neoplasm with admixed carcinomatous and sarcomatous elements; overlying urothelial carcinoma in situ<

GATA3 and CK7 highlight both the carcinomatous and bizarre sarcomatoid cells

Positive stains
Molecular / cytogenetics description
Differential diagnosis
Back to top