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Prognostic Significance and Nature of Rhabdoid Features in Renal Cell Carcinoma

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Ãֹ̼±, ȲÀϼ±, ¹ÚÁö¿µ, ±è»óÇ¥,
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Ãֹ̼± ( Choe Mi-Sun ) 
Keimyung University School of Medicine Department of Pathology

ȲÀϼ± ( Hwang Il-Seon ) 
Keimyung University College of Medicine Department of Pathology
¹ÚÁö¿µ ( Park Ji-Young ) 
Keimyung University College of Medicine Department of Pathology
±è»óÇ¥ ( Kim Sang-Pyo ) 
Keimyung University College of Medicine Department of Pathology

Abstract


Background: Recent reports have indicated that renal cell carcinoma (RCC) with rhabdoid features follows an aggressive clinical course. We investigated the prognostic significance and nature of the rhabdoid component.

Methods: We retrospectively analyzed the incidence and clinicopathologic characteristics of RCC with rhabdoid features in 174 radical nephrectomy cases. The specimens were examined histologically and immunohistochemically.

Results: Twelve of the 174 RCC cases (6.9%) showed rhabdoid features. Histologically, all the tumors with rhabdoid features were of the clear cell type. The presence of rhabdoid features was significantly associated with higher Fuhrman¡¯s nuclear grade and higher pathologic tumor stage at presentation. Among the 12 patients who showed the rhabdoid component, nine (75%) developed metastasis and seven (58.3%) died of disease-related causes. The presence of rhabdoid features was independently associated with metastasis and disease-related mortality. The rhabdoid cells were positive for vimentin; variably positive for pan-cytokeratin, epithelial membrane antigen, and CD10; and negative for cytokeratin 7, smooth muscle actin, desmin, E-cadherin, and c-Kit. No case showed loss of integrase interactor-1; one was p53 positive, and five were insulin-like growth factor mRNA binding protein 3 positive. The Ki-67 labeling index was 1-25% (mean, 5.5%).

Conclusions: The rhabdoid component is an independent prognostic factor for metastasis of RCC; therefore, identification of this component is critical.

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Carcinoma;renal cell;Kidney;Rhabdoid tumor;Prognosis;Metastasis

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