Pathologic and Clinical Characteristics of Early Onset Renal Cell Carcinoma

Publication date: Available online 11 November 2017
Source:Human Pathology
Author(s): Tyler Clemmensen, Andres Matoso, Tiffany Graham, Win Shun Lai, Soroush Rais-Bahrami, Jennifer Gordetsky
The majority of RCCs occur within the 7th decade of life, uncommonly arising in adults ≤46years. We reviewed the clinicopathologic features of early-onset renal cell carcinoma (RCC) and evaluated the role of immunohistochemistry (IHC) in potentially identifying diagnoses of newly recognized RCC subtypes that may have been previously misclassified. A retrospective review was performed from 2011–2016 for cases of RCC. Early-onset RCC was defined as ≤46years of age. Clinicopathologic findings and hematoxylin and eosin (H&E) slides were reviewed on early-onset RCC patients. IHC was performed on all cases previously diagnosed as unclassified or papillary. Clinicopathologic findings were compared to a control group of RCC patients >46years over the same time period. We identified 98/598 (16.4%) early-onset RCCs. The median age in the early-onset RCC and control group was 38.4 and 62.8years, respectively. The early-onset RCC group contained 33/96(34.3%) females and 63/96(65.6%) males, including 52/96(54.2%) Caucasians, 39/96(40.6%) African Americans, 4/96(4.2%) Hispanics, and 1/96(1%) Asian. Non-Caucasians were significantly more likely to develop early-onset RCC (P=.004). Early-onset RCCs included 52% clear cell, 28.6% papillary, 8.2% unclassified, 5.1% chromophobe, 3.1% clear cell papillary(CCP), and 3 other rare tumors. Six unclassified and 26 papillary RCCs had tissue available for IHC. 2/6(33.3%) unclassified RCCs were reclassified (1 CCP, 1 Xp11 translocation). 1/26(3.8%) papillary RCCs was reclassified as CCP. Early-onset RCCs were more likely to occur in non-Caucasians (P=.004), be lower stage (P=.03), and undergo partial nephrectomy (P=.002). Few unclassified and papillary tumors were reclassified with IHC.



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