Metanephric adenosarcoma in a young adult: Morphologic, immunophenotypic, ultrastructural, and fluorescence in situ hybridization analyses: A case report and review of the literature

Maria M. Picken, Jonathan L. Curry, Valerie Lindgren, Joseph I. Clark, John N. Eble

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Metanephric neoplasms are uncommon renal tumors that arise in both children and adults. They may be composed of small epithelial cells or benign stroma, or both, and are termed metanephric adenoma, metanephric stromal tumor, or metanephric adenofibroma, respectively. Thus far, these tumors have been known for their benign behavior. We present the case of a 21-year-old woman who developed a neoplasm composed of a renal epithelial component identical to metanephric adenoma combined with a malignant spindle cell sarcoma. The epithelial component was positive for pankeratin AE1/3, whereas the sarcomatous component was negative for epithelial markers and positive for vimentin, CD34, and CD117. No smooth muscle differentiation was apparent in the sarcoma by immunohistochemistry or ultrastructural analysis. By fluorescent in situ hybridization analysis of the sarcomatous component there was monosomy of the X chromosome, but no apparent variation from the normal diploid pattern for chromosomes 3, 7, 12, and 17. We conclude that the spectrum of metanephric neoplasia should be expanded to include malignant stromal variants, and we propose the term "metanephric adenosarcoma" for the present case.

Original languageEnglish (US)
Pages (from-to)1451-1457
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume25
Issue number11
DOIs
StatePublished - Nov 12 2001

Keywords

  • Kidney
  • Metanephric adenofibroma
  • Metanephric adenoma
  • Metanephric neoplasia
  • Prognosis
  • Renal cell carcinoma
  • Wilms' tumor

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

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