Sarcomatoid renal cell carcinoma with osteogenic differentiation and paraneoplastic hepatopathy in a dog, possibly related to human Stauffer's syndrome

Primary renal mixed tumor characterized by marked proliferation of osteoblast-like cells with osteoid formation in a swine

Renal mixed tumor characterized by the absence of nephrogenic blastema and the presence of predominant osteoid-producing osteoblast-like cells occurred in the kidney of a 6-month-old, hybrid, female pig. At the post-mortem examination, the tumor was found as a calcified grayish-white mass at the cranial end of the left kidney. Histologically the tumor consisted of 3 growth areas of poorly differentiated spindle cells, osteoid-producing osteoblast-like cells, and luminal epithelial cells. Transition from the spindle cells to the osteoblast-like cells or the luminal epithelial cells was observed. Immunohistochemically, the spindle cells and the osteoblast-like cells were consistently positive for β-catenin. Although the luminal epithelial cells and adjacent spindle cells were positive for cytokeratin, these 3 types of tumor cells were consistently negative for WT1. The tumor was diagnosed as primary renal mixed tumor characterized by marked proliferation of osteoblast-like cells with osteoid formation.

Sarcomatoid renal cell carcinoma with scant epithelial components in an Angora cat

CASE HISTORY

A 6-year-old, neutered, female Angora cat presented with a history of lethargy and anorexia for 2 months and a clinically palpable and gradually enlarging, solid mass in the abdominal cavity extending from the last costal arch to the pelvic cavity.

CLINICAL FINDINGS

Examination of the cat revealed jaundice, dehydration and hypothermia. Haematological manifestations included lymphopenia and substantial decrease in haematocrit value. Biochemical analysis of the blood revealed hypoglycaemia, three-fold elevated blood urea nitrogen values, increased level of serum aspartate aminotransferase and increased total bilirubin while the creatinine level was normal. Ultrasonographic examination of the abdomen showed a disrupted and large hypoechoic area around the left kidney. The cat was anaesthetised and the left kidney was removed, but the cat died following surgery.

PATHOLOGICAL FINDINGS

On post-mortem examination, the left kidney was markedly enlarged and both the cortical and medullary parenchyma were replaced by confluent, multilobulated, pale tan-white, firm nodular masses protruding above the capsular surface. Metastasis was not observed. Cytological examination revealed a population of spindle-shaped cells of variable size, with abundant coarse chromatin and occasionally prominent nucleoli. Initial sections of the kidney were indicative of undifferentiated sarcoma confirmed by immunohistochemistry revealing vimentin-positive and cytokeratin-negative results in all tumour tissues. Additional sections showed very small amounts of both cytokeratin-positive and vimentin-positive areas.

DIAGNOSIS

Sarcomatoid renal cell carcinoma (SRCC) with scant epithelial components originating from left kidney.

CLINICAL RELEVANCE

Clinical and pathological features were similar to those of human SRCC, even though there was no evidence of metastases. Immunohistochemistry for vimentin and cytokeratin may be useful for definitive diagnosis of renal cell carcinoma with sarcomatoid differentiation, although staining of sections from several different parts of the tumour may be necessary. When a primary renal tumour is presented, SRCC should be considered as this diagnosis may influence treatment protocols and the clinical outcome.

Immunohistochemical Characterization of 13 Canine Renal Cell Carcinomas

Canine renal cell carcinomas (RCCs) are uncommon aggressive tumors that occur mainly in middle-aged male dogs. Their histologic classification bears no relationship with prognosis, and little information is available concerning their immunohistochemical properties. In this retrospective study, formalin-fixed, paraffin-embedded tissues from 13 canine RCCs were retrieved from the archives, classified histologically, and evaluated immunohistochemically. The dogs were 7 males and 6 females (1 spayed) of 10 different breeds, averaging 8 years in age. The tumors were classified as papillary, tubulopapillary, papillary–cystic, solid, or sarcomatoid. All 13 tumors were immunohistochemically positive for uromodulin, 12 for c-KIT, 11 for vimentin, 9 for wide-spectrum-screening cytokeratins, 7 for cytokeratins AE1/AE3 and carcinoembryonic antigen, 4 for cytokeratins CAM 5.2, and 3 for CD10. All 3 solid RCCs expressed vimentin, c-KIT, and carcinoembryonic antigen and were negative for cytokeratins. All 7 papillary and tubulopapillary tumors expressed vimentin; 6 (86%), cytokeratins; and 6 (86%), c-KIT. Both papillary–cystic RCCs were positive for cytokeratins and c-KIT and negative for vimentin. These results indicate that the different histologic types of RCC have characteristic immunohistochemical profiles and that c-KIT may be involved in the pathogenesis of canine RCC.

Hypertrophic osteopathy associated with disseminated metastases of renal cell carcinoma in the dog: a case report

A 6-year-old, mixed breed, intact male dog showed signs of left carpal joint swelling and weakness of the forelimbs one month before presentation. The symptoms gradually progressed to bilateral carpal and tarsal joint swelling and tetraparalysis. There were a number of radiographically identified lytic-proliferative bone lesions noted on the axial skeleton. Hypertrophic osteopathy of the metacarpi and all distal long bones was also evident. Because of the deteriorating quality of life and guarded prognosis, the patient was euthanized and a complete necropsy was performed. Renal cell carcinoma, with metastasis to the lung, thoracic vertebrae, ribs, and the right adrenal gland, was diagnosed. To our knowledge, renal cell carcinoma with bone metastases and hypertrophic osteopathy has not been reported in dogs.