Abstract
Introduction Renal cell carcinoma (RCC) is the most common malignancy of the kidney, with about 4% of patients having sarcomatoid dedifferentiation. Sarcomatoid features can develop in conjunction with all subtypes of RCC, including clear cell renal carcinoma (8%), papillary renal carcinoma (3%), chromophobe renal carcinoma (9%), and collecting duct carcinoma (29%). As a morphologic diagnosis, saromatoid renal cell carcinoma (SRCC) is defined by the spindled orphologic features of cells, resembling a sarcoma, among a backround of the primary histologic renal carcinoma type. Despite the pindled appearance, SRCC does not routinely express mesenchymal arkers, so epithelial-mesenchymal transition has been proposed as a mechanism for SRCC evolution. Regardless of the percentage of arcomatoid cells present in the tumor, sarcomatoid dedifferentiaion has been associated with a significantly worse prognosis inde-
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