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Clinical History:
29-year-old male with history of adrenocortical
carcinoma. He has had prior chemotherapy and radiation
to his left upper quadrant and has had a prior
adrenalectomy for a large adrenocortical cancer. Now,
the patient has a mass on the anterior surface of his
left kidney.
Histology: Sections show renal cell carcinoma,
clear cell type with papillary architecture,
Fuhrman nuclear grade 2/4.
Special IHC staining for CA-IX in figure B shows patchy
staining of tumor cell membranes. Additional IHC
staining for CK7 is patchy positive in the papillary
aspects of the tumor (Figure C). Staining for racemase is strongly
positive in the tumor cells (Figure D). Staining for TFE3 is
focally positive in tumor cell nuclei (Figure F). This antigenic
profile suggests the presence of a renal cell carcinoma
with papillary architecture.
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