title: Clear cell renal cell carcinoma with syncytial giant cells: a case report and review of the literature.
abstract: Renal cell carcinoma with syncytial giant cells (SGCs) is rare; to our knowledge, there are only 3 cases reported in the English literature. We report on a case that, unlike previous reports, was associated with higher grade renal cell carcinoma and an aggressive behavior. A 63-year-old man with gross hematuria was found to have a large left renal mass and no evidence of metastasis. The nephrectomy specimen contained a 14.8-cm mass that was confined within the renal capsule. Microscopically, a 1.8-cm area of SGCs was noted in a background of clear cell renal cell carcinoma of Fuhrman nuclear grades 2 to 4. The SGCs had voluminous cytoplasm, multiple large nuclei with prominent nucleoli, and focal emperipolesis. Identical to the background mononuclear tumor cells, the SGCs were positive for AE1/AE3, vimentin, and epithelial membrane antigen and negative for CD68, beta-human chorionic gonadotropin, and mucin. Three months after surgery, the patient developed metastases in the liver, right kidney, and lungs.
authors.affiliation: Department of Pathology, The Ohio State University Medical Center, Columbus 43210 , USA.
authors.forename: Rulong
authors.initials: R
authors.lastname: Shen
authors.forename: Ping
authors.initials: P
authors.lastname: Wen
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000175:diagnosis*; D002292:Carcinoma, Renal Cell / Q000175:diagnosis*; D015726:Giant Cells / Q000473:pathology*; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis*