Bladder, ureter & renal pelvis
Urothelial carcinoma-invasive

Topic Completed: 1 October 2015

Minor changes: 15 January 2021

Copyright: 2003-2021,, 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 2020: 2,185
Page views in 2021 to date: 228
Cite this page: Andeen NK, Tretiakova M. Sarcomatoid. website. Accessed January 24th, 2021.
Definition / general
  • Biphasic malignant neoplasm with morphological or immunohistochemical evidence of carcinomatous and sarcomatous differentiation (WHO 2004)
  • 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)
  • Kidney pelvis, proximal ureter
  • 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
  • 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.


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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

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
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