Kidney tumor
Adult renal cell carcinoma
Urothelial carcinoma of renal pelvis - sarcomatoid variant

Author: Nicole K. Andeen, M.D.
Editor: Maria Tretiakova, M.D.

Revised: 19 April 2018, last major update October 2015

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Urothelial carcinoma Sarcomatoid renal pelvis

Related Topics: Urothelial carcinoma of renal pelvis
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Cite this page: Andeen, N.K. Urothelial carcinoma of renal pelvis - Sarcomatoid variant. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/kidneytumormalignanturothelialcarcinomasubtypessarcomatoid.html. Accessed July 21st, 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

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Mass in the left renal pelvis

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

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Sarcomatoid

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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

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

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GATA3 and CK7 highlight both the carcinomatous and bizarre sarcomatoid cells

Positive stains
Molecular / cytogenetics description
Differential diagnosis
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