Case ID: 1043

Publication date: 22 Jan, 2016

Consensus grade: Renal cell carcinoma with leiomyomatous stroma

User Diagnosis Difficulty Comment
Pathologist 1 Renal cell carcinoma with leiomyomatous stroma Not typical
Pathologist 2 Renal cell carcinoma with leiomyomatous stroma Typical

We would for TCEB 1 mutation

Pathologist 3 Renal cell carcinoma, unclassified Not typical

Since there is a lot of pink stroma, this is probably thought to be clear cell renal cell carcinoma with leiomyomatous stroma but the photos show a stroma which looks fibrous to me so garden variety clear cell renal cell carcinoma is a better diagnosis for the photos.

Pathologist 4 Clear cell RCC Not typical
Pathologist 5 Renal cell carcinoma with leiomyomatous stroma Not typical
Pathologist 6 Renal cell carcinoma with leiomyomatous stroma Not typical
Pathologist 7 Clear cell RCC Not typical
Pathologist 8 Renal cell carcinoma with leiomyomatous stroma Typical
Pathologist 9 Renal cell carcinoma with leiomyomatous stroma Typical
Pathologist 10 Renal cell carcinoma with leiomyomatous stroma Typical
Pathologist 11 Renal cell carcinoma with leiomyomatous stroma Typical

hard to be sure the stroma is muscle in these images

Pathologist 12 Clear cell RCC Typical
Pathologist 13 Renal cell carcinoma with leiomyomatous stroma Typical
Pathologist 14 Renal cell carcinoma, unclassified Not typical
Pathologist 15 Renal cell carcinoma with leiomyomatous stroma Typical
Pathologist 16 Renal cell carcinoma with leiomyomatous stroma Typical
Pathologist 17 Renal cell carcinoma with leiomyomatous stroma Typical
Pathologist 18 Renal cell carcinoma with leiomyomatous stroma Typical
Pathologist 19 Renal cell carcinoma with leiomyomatous stroma Typical
Pathologist 20 Clear cell RCC Not typical
Pathologist 21 Renal cell carcinoma with leiomyomatous stroma Typical
Pathologist 22 Renal cell carcinoma with leiomyomatous stroma Typical
Pathologist 23 Clear cell RCC Typical


Case description (by case creator):

Kidney tumor, male 62-year-old. Tumor well circumscribed, yellow color with gray strands on gross section. Tumor composed of clear cell elements resembling cells of typical clear cell RCC. Fibroleiomyomatous stroma was prominent. No sarcomatoid changes were present.
Tumor is positive for CK 7, vimentin. Using next generation sequencing, no abnormalities of VHL gene (methylation, mutation, LOH3p) and TCEB1 gene were disclosed.
Dg: Renal cell carcinoma with (fibro)leiomyomatous stroma