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Case 474 - Discussion

Uploaded: 2011-02-10, Updated: 2011-02-10

 

Metastatic Renal Cell Carcinoma

  • The patient had history of RCC with a nephrectomy one year ago.

  • Metastatic RCC may present in various locations many years before or after the identification of the primary tumor.

  • Metastatic RCC typically shows nests of clear cells in a vascular background with areas of necrosis. The tumor many not have clear cytoplasm, and may reveal spindle or pleomorphic morphology.

  • Differential diagnosis of tumors with clear cell morphology:

    • Metastatic RCC: Vimentin+, RCC+, CD10+, PAX8+, inhibin-

    • Hemangioblastoma: inhibin+

    • Adrenal cortical adenoma: inhibin+

    • Sugar cell tumor of lung

    • Parotid tumor with clear cell features: acinic cell carcinoma, myoepithelioma