Sarcomatoid renal cell carcinoma

Case contributed by Dr Matt A. Morgan


Discovered in a workup for osseous metastatic disease of unknown primary.

Patient Data

Age: 80 years
Gender: Male

CT of the left kidney

Irregular mass extending off the superolateral aspect of the left kidney. There is questionable involvement of the splenic flexure of the colon.


Core biopsy

Ultrasound-guided core biopsy (20 gauge) of the periphery of the mass.

Case Discussion

Sarcomatoid renal cell carcinoma (sRCC) is not currently thought to represent a distinct histologic subtype of renal cell carcinoma (RCC), but represents a "final common dedifferentiation pathway." It occurs in ~16% of advanced RCCs.

sRCC develops out of advanced RCC and typically presents as a large necrotic mass with >50% having metastatic disease at presentation.

Imaging appearance of sRCC is nonspecific and there are few series in the literature attempting to characterize it.

The histologic distinction between sarcomatous RCC and advanced nonsarcomatous RCC is important for prognostic purposes since sRCC is a very aggressive variant and has a poorer prognosis. 

The original histologic subtype in this particular case of sRCC is unknown.

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Case information

rID: 32919
Published: 21st Dec 2014
Last edited: 11th Sep 2020
System: Urogenital
Inclusion in quiz mode: Included

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