Background: MED15-TFE3 renal cell carcinoma is a rare subtype of the Xp11 translocation renal cell carcinoma. To data, only 14 cases of MED15-TFE3 renal cell carcinoma have been reported worldwide.Methods: MED15-TFE3 gene fusion was identified in two cases of Xp11 translocation renal cell carcinoma by using RNA-sequencing. We reviewed and summarized the clinicopathological characteristics, imaging features and prognosis of the MED15-TFE3 renal cell carcinoma. Results: Morphologically, MED15-TFE3 RCC have the typical cystic-solid (mostly cystic) structure. The tumor cells had round nuclei with inconspicuous nucleoli and abundant clear or eosinophilic cytoplasm. Psammoma bodies were randomly distributed within the stroma. Immunohistochemically, the typical TFE3 positive staining could be observed in both cases. The split red-green signal also revealed the positive results in fluorescence in situ hybridization (FISH) assay. Finally, RNA sequencing detected the existence of MED15-TFE3 gene fusion. One pediatric patient developed renal hilar lymph node metastasis before surgery. However, during the follow-up period, no disease recurrence and metastasis happened to both patients. Conclusions: Different from the traditional Xp11 translocation RCC, MED15-TFE3 RCC may have the distinctive cystic-solid structure and superior prognosis. These findings enhanced our understanding of the heterogeneity in Xp11 translocation RCC.
Background The aim of this study was to investigate the peritumoral pseudocapsule (PC) status and identify the factors influencing PC status in small renal cell carcinoma (RCCs). Methods A total of 147 patients with small RCC (≤4 cm) who had undergone tumor enucleation (TE) were assigned into three groups according to PC status: complete PC, PC absence, and PC invasion. Computed tomography (CT) imaging and clinicopathological features were compared among the three groups. Univariate and multivariate analyses were performed to identify factors associated with incomplete PC. Results The number of patients with complete PC, PC absence, and PC invasion was 87 (59%), 20 (14%), and 40 (27%), respectively. Compared with the other two groups, tumors with complete PC were most common in clear cell RCC (CCRCC) and showed a hyperenhancement pattern (92%) and clear boundary (63%) on CT scanning images (p < 0.001). PC absence was most common in female patients (50%), whereas PC invasion was more common in male patients (85%) (p = 0.017). The tumor diameter in the PC absence group (2.24 ± 0.93 cm) was shorter compared with that of the complete PC group (2.88 ± 0.76 cm) and PC invasion group (3.16 ± 0.64 cm) (p < 0.001). Univariate and multivariate analysis showed that hypoenhancement pattern, unclear boundary, and non‐CCRCC subtype were independent risk factors of incomplete PC. Conclusions Hypoenhancement pattern, unclear boundary, and non‐CCRCC subtype were significant predictors of incomplete PC in small RCCs. It remains to be established whether TE is an appropriate procedure for patients with incomplete PC.
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