Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists

Oncocytic renal neoplasms are a major source of diagnostic challenge in genitourinary pathology; however, they are typically nonaggressive in general, raising the question of whether distinguishing different subtypes, including emerging entities, is necessary. Emerging entities recently described include eosinophilic solid and cystic renal cell carcinoma (ESC RCC), low-grade oncocytic tumor (LOT), eosinophilic vacuolated tumor (EVT), and papillary renal neoplasm with reverse polarity (PRNRP). A survey was shared among 65 urologic pathologists using SurveyMonkey.com (Survey Monkey, Santa Clara, CA, USA). De-identified and anonymized respondent data were analyzed. Sixty-three participants completed the survey and contributed to the study. Participants were from Asia (n = 21; 35%), North America (n = 31; 52%), Europe (n = 6; 10%), and Australia (n = 2; 3%). Half encounter oncocytic renal neoplasms that are difficult to classify monthly or more frequently. Most (70%) indicated that there is enough evidence to consider ESC RCC as a distinct entity now, whereas there was less certainty for LOT (27%), EVT (29%), and PRNRP (37%). However, when combining the responses for sufficient evidence currently and likely in the future, LOT and EVT yielded > 70% and > 60% for PRNRP. Most (60%) would not render an outright diagnosis of oncocytoma on needle core biopsy. There was a dichotomy in the routine use of immunohistochemistry (IHC) in the evaluation of oncocytoma (yes = 52%; no = 48%). The most utilized IHC markers included keratin 7 and 20, KIT, AMACR, PAX8, CA9, melan A, succinate dehydrogenase (SDH)B, and fumarate hydratase (FH). Genetic techniques used included TSC1/TSC2/MTOR (67%) or TFE3 (74%) genes and pathways; however, the majority reported using these very rarely. Only 40% have encountered low-grade oncocytic renal neoplasms that are deficient for FH. Increasing experience with the spectrum of oncocytic renal neoplasms will likely yield further insights into the most appropriate work-up, classification, and clinical management for these entities.

Authors

Institutions

Publication Details

Journal
Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin
Published
2024-09-17
DOI
https://doi.org/10.1007/s00428-024-03909-2
Citations
5
Primary Topic
Renal cell carcinoma treatment
Type
article
Field-Weighted Citation Impact
2.09
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists

Fiona Maclean, Sean R. Williamson, Ying‐Bei Chen, Maria Tretiakova et al.
5 citations
Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin
Renal cell carcinoma treatment
2.09
article

Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists

Fiona Maclean, Sean R. Williamson, Ying‐Bei Chen, Maria Tretiakova, Rohit Mehra, Lisa Browning, Sangeeta Desai, Kiril Trpkov, Mahmut Akgül, Anandi Lobo, Samson W. Fine, Bijal Kulkarni, Hikmat A Al‐Ahmadie, Brett Delahunt, Michelle S. Hirsch, Satish K. Tickoo, Sambit K. Mohanty, Shivani Kandukuri, Christopher G. Przybycin, Sara E. Wobker, José I. López, Gladell P. Paner, Ondřej Hes, Mohammed A. Amin, Manju Aron, Vipra Malik, Jesse K. McKenney, Mukund Sable, Deepika Sirohi, Guido Martignoni, Niharika Pattnaik, Mallika Dixit, Priya Rao, Suvradeep Mitra, Claudia Manini, Jonathan I. Epstein, Seema Kaushal, Rajal B. Shah, Naoto Kuroda, Giovanna A. Giannico, Ankur R. Sangoi, Sankalp Sancheti, Steven C. Smith, Anil Vasdev Parwani, Ekta Jain, Divya Midha, Vishal Rao, Deepika Jain, Samriti Arora, Liang Cheng, Maria M. Picken, Daniel Luthringer, Ming Zhou, Shivani Sharma, Nilesh Gupta, Shailesh Soni, Amit Kumar Adhya, Santosh Menon, John R. Srigley, Pritinanda Mishra, Holger Moch, Lakshmi P. Kunju, Shilpy Jha, Victor E Reuter, Manas Baisakh
article en
5 citations

Abstract

Oncocytic renal neoplasms are a major source of diagnostic challenge in genitourinary pathology; however, they are typically nonaggressive in general, raising the question of whether distinguishing different subtypes, including emerging entities, is necessary. Emerging entities recently described include eosinophilic solid and cystic renal cell carcinoma (ESC RCC), low-grade oncocytic tumor (LOT), eosinophilic vacuolated tumor (EVT), and papillary renal neoplasm with reverse polarity (PRNRP). A survey was shared among 65 urologic pathologists using SurveyMonkey.com (Survey Monkey, Santa Clara, CA, USA). De-identified and anonymized respondent data were analyzed. Sixty-three participants completed the survey and contributed to the study. Participants were from Asia (n = 21; 35%), North America (n = 31; 52%), Europe (n = 6; 10%), and Australia (n = 2; 3%). Half encounter oncocytic renal neoplasms that are difficult to classify monthly or more frequently. Most (70%) indicated that there is enough evidence to consider ESC RCC as a distinct entity now, whereas there was less certainty for LOT (27%), EVT (29%), and PRNRP (37%). However, when combining the responses for sufficient evidence currently and likely in the future, LOT and EVT yielded > 70% and > 60% for PRNRP. Most (60%) would not render an outright diagnosis of oncocytoma on needle core biopsy. There was a dichotomy in the routine use of immunohistochemistry (IHC) in the evaluation of oncocytoma (yes = 52%; no = 48%). The most utilized IHC markers included keratin 7 and 20, KIT, AMACR, PAX8, CA9, melan A, succinate dehydrogenase (SDH)B, and fumarate hydratase (FH). Genetic techniques used included TSC1/TSC2/MTOR (67%) or TFE3 (74%) genes and pathways; however, the majority reported using these very rarely. Only 40% have encountered low-grade oncocytic renal neoplasms that are deficient for FH. Increasing experience with the spectrum of oncocytic renal neoplasms will likely yield further insights into the most appropriate work-up, classification, and clinical management for these entities.

Archiv für Pathologische Anatomie und Physiologie und für Klinische MedicinVol. 485(5)
Boston University (US), University of North Carolina at Chapel Hill (US), University of Verona (IT), Tufts University (US), Cedars-Sinai Medical Center (US), Brigham and Women's Hospital (US), All India Institute of Medical Sciences Raipur (IN), Loyola University Medical Center (US), Cleveland Clinic (US), Memorial Sloan Kettering Cancer Center (US), The University of Texas MD Anderson Cancer Center (US), Henry Ford Health System (US), University of Tennessee Health Science Center (US), University of Calgary (CA), Virginia Commonwealth University (US), University of Washington (US), Brown University (US), University of Michigan (US), Tata Memorial Hospital (IN), Keck Hospital of USC (US), Muljibhai Patel Urological Hospital (IN), El Camino Hospital (US), Wellington Hospital (NZ), Garden City Community College (US), Oxford Health NHS Foundation Trust (GB), Credit Valley Hospital (CA), University of Oxford (GB), University of Chicago (US), Victoria University of Wellington (NZ), Tata Medical Center (IN), ARUP Laboratories (United States) (US), Southwestern Medical Center (US), Basavatarakam Indo American Cancer Hospital and Research Institute (IN), University Hospital of Zurich (CH), Douglass Hanly Moir Pathology (AU), All India Institute of Medical Sciences Bhubaneswar (IN), Cancer Hospital and Research Institute (IN), Japanese Red Cross Kochi Hospital (JP), Biopticka Laborator (Czechia) (CZ), Apollo Hospitals (IN), Kokilaben Dhirubhai Ambani Hospital (IN), Hospital de Cruces (ES), Advanced Medical Research Institute (US), Southwestern Medical Center (US), Post Graduate Institute of Medical Education and Research (IN), The Ohio State University (US), University of Turin (IT), Seattle University (US), All India Institute of Medical Sciences (IN), Albany Medical Center Hospital (US), The University of Texas Southwestern Medical Center (US), Vanderbilt University Medical Center (US)
Good health and well-being
Openalex Percentile: Top 12%
Renal cell carcinoma treatment
2.09
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.