A Novel Prognostic Criteria and Targeted Therapy in Sarcomatoid Variant of Chromophobic Renal Cell Carcinoma
V. V. Ermilov, O. V. Dolzhanski, A. Agarwal, H. A. Mouhammed
International Research Journal of Oncology · pp. 85–97 · Published 14 Sep 2019
Abstract
Chromophobic renal cell carcinoma (CRCC) is a rare subtype of renal cell carcinoma, accounting for only 5.9% of epithelial kidney tumors. This study reports the findings studied in chromophobic renal cell carcinoma case with sarcomatoid differentiation in a 66-year-old patient admitted in Federal State Budgetary Institution (FSBI). This study concludes that, the criteria of aggressive behavior for chromophobic renal cell carcinoma include the following characteristics: The size of the tumor more than 7.0 cm; presence of necrosis; grade III according to Paner et al. classification; sarcomatoid differentiation (more than 30.0%); positive reaction with common acute lymphocytic leukemia antigen (CD10); nuclear expression of p53 in more than 80.0% of tumor cells; proliferation marker Ki67 in more than 9.0% of tumor cells. In this case, the indication for targeted therapy was sarcomatoid differentiation (in more than 10.0% of the tumor) and a strong reaction with Vascular endothelial growth factor; 5-6 points ((VEGF-A).
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