Restricted accessCase reportFirst published online 2018-2
Malignant Mixed Epithelial and Stromal Tumor of the Kidney With 2 Simultaneous Renal Carcinomas in a Male Patient: Case Report and Review of the Literature
The majority of mixed epithelial and stromal tumors (MEST) of the kidney are benign entities found in female patients. Malignant MEST of the kidney is an extremely rare entity that often behaves clinically similar to an undifferentiated sarcoma. We report a case of a malignant MEST with synchronous papillary and clear cell renal cell carcinomas (RCCs) in a 61-year-old Caucasian man who presented with an incidental finding of a left renal mass on workup for back pain. The patient underwent a left radical nephrectomy, with histopathology confirming a malignant MEST, intimately associated papillary RCC, and separate adjacent focus of clear cell RCC.
FineSWReuterVEEpsteinJIArganiP.Angiomyolipoma with epithelial cysts (AMLEC): a distinct cystic variant of angiomyolipoma. Am J Surg Pathol. 2006;30:593-539.
2.
WeiJLiYWenYLiLZhangR.Renal angiomyolipoma with epithelial cysts: a rare entity and review of literature. Int J Clin Exp Pathol. 2015;8:11760-11765.
3.
MichalMSyrucekM.Benign mixed epithelial and stromal tumor of the kidney. Pathol Res Pract. 1998;194:445-448.
4.
MichalM.Benign mixed epithelial and stromal tumor of the kidney. Pathol Res Pract. 2000;196:275-276.
5.
AdsayNVEbleJNSrigleyJRJonesECGrignonDJ.Mixed epithelial and stromal tumor of the kidney. Am J Surg Pathol. 2000;24:958-970.
6.
ZhouMKortEHoekstraPet alAdult cystic nephroma and mixed epithelial and stromal tumor of the kidney are the same disease entity: molecular and histologic evidence. Am J Surg Pathol. 2009;33:72-80.
7.
SuzukiTHiragataSHosakaKet alMalignant mixed epithelial and stromal tumor of the kidney: report of the first male case. Int J Urol. 2013;20:448-450.
8.
ZouLZhangXXiangH.Malignant mixed epithelial and stromal tumor of the kidney: the second male case and review of literature. Int J Clin Exp Pathol. 2014;7:2658-2663.
9.
VanecekTPivovarcikovaKPitraTet alMixed epithelial and stromal tumor of the kidney: mutation analysis of the DICER 1 gene in 29 cases. Appl Immunohistochem Mol Morphol. 2017;25:117-121.
10.
KumJBGrignonDJWangMet alMixed epithelial and stromal tumors of the kidney: evidence for a single cell of origin with capacity for epithelial and stromal differentiation. Am J Surg Pathol. 2011;35:1114-1122.
11.
YangYOndrejHZhangLet alMixed epithelial and stromal tumor of the kidney with cervical and intestinal differentiation. Virchows Arch. 2005;447:669-671.
12.
ChuPGLauSKWeissLMJiangZ.Intestinal type of mucinous borderline tumor arising from mixed epithelial and stromal tumor of kidney. Virchows Arch. 2009;455:389-394.
13.
TurbinerJAminMBHumphreyPAet alCystic nephroma and mixed epithelial and stromal tumor of kidney: a detailed clinicopathologic analysis of 34 cases and proposal for renal epithelial and stromal tumor (REST) as a unifying term. Am J Surg Pathol. 2007;31:489-500.
14.
YapYSColemanMOlverI.Aggressive mixed epithelial-stromal tumour of the kidney treated with chemotherapy and radiotherapy. Lancet Oncol. 2004;5:747-749.
15.
NakagawaTKanaiYFujimotoHet alMalignant mixed epithelial and stromal tumours of the kidney: a report of the first two cases with a fatal clinical outcome. Histopathology. 2004;44:302-304.
16.
JungSJShenSSTranTet alMixed epithelial and stromal tumor of kidney with malignant transformation: report of two cases and review of literature. Hum Pathol. 2008;39:463-468.
17.
OzlukYSariSOGuzelNTFiratPAkbulutFKilicaslanI.Mixed epithelial and stromal tumor of the kidney with sarcomatous transformation metastatic to the lung: a case report. Anal Quant Cytopathol Histpathol. 2015;37:199-205.
18.
SvecAHesOMichalMZachovalR.Malignant mixed epithelial and stromal tumor of the kidney. Virchows Arch. 2001;439:700-702.
19.
ShenSSTruongLDAyalaAGRoJY.Recently described and emphasized entities of renal neoplasms. Arch Pathol Lab Med. 2007;131:1234-1243.
20.
KurodaNSakaidaNKinoshitaHet alCarcinosarcoma arising in mixed epithelial and stromal tumor of the kidney. APMIS. 2008;116:1013-1015.
21.
MenéndezCLRodríguezVDFernández-PelloSet alA new case of malignant mixed epithelial and stromal tumor of the kidney with rhabdomyosarcomatous transformation. Anal Quant Cytopathol Histpathol. 2012;34:331-334.
22.
MudaliarKMMehtaVGuptaGNPickenMM.Expanding the morphologic spectrum of adult biphasic renal tumors: mixed epithelial and stromal tumor of the kidney with focal papillary renal cell carcinoma: case report and review of the literature. Int J Surg Pathol. 2014;22:266-271.
23.
SukovWRChevilleJCLagerDJLewinJRSeboTJLewinM.Malignant mixed epithelial and stromal tumor of the kidney with rhabdoid features: report of a case including immunohistochemical, molecular genetic studies and comparison to morphologically similar renal tumors. Hum Pathol. 2007;38:1432-1437.
24.
FariasJALaryeaJGokdenNKamelMH.Peritoneal seeding following incomplete resection of mixed epithelial stromal tumor of the kidney: first case report. Urol Ann. 2016;8:114-117.
25.
BiscegliaMBacchiCE.Mixed epithelial-stromal tumor of the kidney in adults: two cases from the Arkadi M Rywlin slide seminars. Adv Anat Pathol. 2003;10:223-233.
