Characteristic MRI findings of sarcomatoid renal cell carcinoma dedifferentiated from clear cell renal carcinoma: radiological–pathological correlation

Takeuchi, Mitsuru; Urano, Misugi; Hara, Masaki; Fujiyoshi, Yukio; Inagaki, Hiroshi; Shibamoto, Yuta

doi:10.1016/j.clinimag.2013.04.010

Cited by 20 publications

(39 citation statements)

References 25 publications

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“…In texture analysis, the global heterogeneity features (lengthwise nonuniformity and greater gray-level nonuniformity) manifested in SRCC more than in CRCC [ 12 ]. Takeuchi et al evaluated findings of SRCC on MRI and found that the presence of low signal intensity (SI) on T2-weighted images (T2LIA) corresponding to the area showing a hypovascular nature and markedly restricted diffusion might be characteristic findings of SRCC [ 13 ]. In the study, nodules with low SI within a heterogeneous mass with high SI and a mixed or separated pattern of high SI on T2-weighted images (T2HIA) and T2LIA were characteristic findings of SRCC dedifferentiated from CCRC [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Takeuchi et al evaluated findings of SRCC on MRI and found that the presence of low signal intensity (SI) on T2-weighted images (T2LIA) corresponding to the area showing a hypovascular nature and markedly restricted diffusion might be characteristic findings of SRCC [ 13 ]. In the study, nodules with low SI within a heterogeneous mass with high SI and a mixed or separated pattern of high SI on T2-weighted images (T2HIA) and T2LIA were characteristic findings of SRCC dedifferentiated from CCRC [ 13 ]. It is pathologically confirmed that T2HIA and T2LIA on MRI roughly corresponded to CCRC and SRCC, respectively [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the study, nodules with low SI within a heterogeneous mass with high SI and a mixed or separated pattern of high SI on T2-weighted images (T2HIA) and T2LIA were characteristic findings of SRCC dedifferentiated from CCRC [ 13 ]. It is pathologically confirmed that T2HIA and T2LIA on MRI roughly corresponded to CCRC and SRCC, respectively [ 13 ]. In another study, Takeuchi et al defined heterogeneous renal tumors with 1–3 cm T2LIAs as a probable SRCC finding and tumors with > 3 cm T2LIAs, > 1 cm multiple T2LIAs, or disruption of the pseudocapsule as definite SRCC findings to investigate the usefulness of MRI for detection of SRCC components within RCC and differentiation from other renal tumors [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…In another study, Takeuchi et al defined heterogeneous renal tumors with 1–3 cm T2LIAs as a probable SRCC finding and tumors with > 3 cm T2LIAs, > 1 cm multiple T2LIAs, or disruption of the pseudocapsule as definite SRCC findings to investigate the usefulness of MRI for detection of SRCC components within RCC and differentiation from other renal tumors [ 14 ]. Intratumoral hemorrhage and necrosis were seen, but these imaging features are non-specific [ 13 , 15 ]. Recently, for an integrated diagnostic approach between radiology and genomics, the term radiogenomics has been established [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Sarcomatoid renal cell carcinoma: a case report and literature review

Xiang¹,

Yp²,

Peng-cheng³

et al. 2018

BMC Nephrol

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BackgroundThe poorly differentiated renal cell carcinoma (RCC) with rhabdomyosarcomatous sarcomatoid differentiation shows a severely aggressive biological behavior characterized by rapid disease progression. Preoperative identification of the subtype with the prognostic factors and imaging features of sarcomatoid renal cell carcinoma (SRCC) would be of great clinical significance.Case presentationA 45-year-old male patient presented a nine day history of gross hematuria without any other symptoms. A computed tomography (CT) and a full-body fluorine-18 fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) - computed tomography (CT) scan urogram were performed. An initial diagnosis identified a space-occupying lesion of the right kidney, retroperitoneal and right renal hulum lymph node metastases, as well as a space-occupying lesion of the third thoracic vertebra (T3). A right radical nephrectomy was performed. Pathologic analysis revealed poorly differentiated RCC with rhabdomyosarcomatous sarcomatoid differentiation that extends into the renal sinus and the ureteral (T3N1M1). Five days later, the Magnetic Resonance imaging (MRI) evidenced a diffused osseous metastatic disease in the thoracic and lumbar vertebra and multiple retroperitoneal lymph node metastases. The disease progressed quickly to multiple organ dysfunction syndrome (MODS) in half a month and the patient died of respiratory failure two days later. The patient refused any chemoradiotherapy in the hospital.ConclusionsOur case presents a SRCC with severe, aggressive, and rapid disease progression. Classifying SRCC imaging features by CT, MRI as well as PET-CT techniques could potentially be helpful for preoperative identification of the subtype. The prognostic factors of SRCC would be of great clinical interest.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sarcomatoid renal cell carcinoma: a case report and literature review

Xiang¹,

Yp²,

Peng-cheng³

et al. 2018

BMC Nephrol

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“…143 It has been suggested that a nodular T2 hypointense hypovascular focus with decreased ADC within a clear cell RCC may suggest sarcomatoid transformation. 144 …”

Section: Clinical Role Of Mri In Advanced Diseasementioning

confidence: 99%

MRI Phenotype in Renal Cancer

Campbell¹,

Rosenkrantz²,

Pedrosa³

2014

Topics in Magnetic Resonance Imaging

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Renal cell carcinoma (RCC) is most commonly diagnosed as an incidental finding on cross-sectional imaging and represents a significant clinical challenge. Although most patients have a surgically curable lesion at the time of diagnosis, the variability in the biologic behavior of the different histologic subtypes and tumor grade of RCC, together with the increasing array of management options, creates uncertainty for the optimal clinical approach to individual patients. State-of-the-art magnetic resonance imaging (MRI) provides a comprehensive assessment of renal lesions that includes multiple forms of tissue contrast as well as functional parameters, which in turn provides information that helps to address this dilemma. In this article, we review this evolving and increasingly comprehensive role of MRI in the detection, characterization, perioperative evaluation, and assessment of the treatment response of renal neoplasms. We emphasize the ability of the imaging “phenotype” of renal masses on MRI to help predict the histologic subtype, grade, and clinical behavior of RCC.

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