Case Series
Volume: 5 | Issue: 8 | Published: Aug 12, 2021 | Pages: 230 - 237 | DOI: 10.24911/ejmcr/173-1611205898
Two cases of aggressive sarcomatoid urothelial carcinoma reveal potential molecular targets
Authors: Alexandria M. Hertz , L. Angelica Lerma , Justin S. Ahn , Judith C. Hagedorn , Eric Q. Konnick , Robin L. Bennett , Petros Grivas , Michael J. Wagner , Nicholas P. Reder , Sarah P. Psutka
Article Info
Authors
Alexandria M. Hertz
Department of Urology, Tripler Army Medical Center, Hospital in Honolulu, Honolulu, HI
L. Angelica Lerma
Department of Pathology, University of Washington, Seattle, WA
Justin S. Ahn
Department of Urology, University of Washington, Seattle, WA
Judith C. Hagedorn
Department of Urology, University of Washington, Seattle, WA
Eric Q. Konnick
Department of Laboratory Medicine, University of Washington, Seattle, WA
Robin L. Bennett
Division of Medical Genetics, University of Washington, Seattle, WA
Petros Grivas
Division of Hematology/Oncology, University of Washington, Seattle, WA
Michael J. Wagner
Division of Hematology/Oncology, University of Washington, Seattle, WA
Nicholas P. Reder
Department of Pathology, University of Washington, Seattle, WA
Sarah P. Psutka
Department of Urology, University of Washington, Seattle, WA.
Publication History
Received: January 21, 2021
Accepted: June 26, 2021
Published: August 12, 2021
Abstract
Background: To detail two cases of sarcomatoid urothelial carcinoma (UC) with rapid progression, disseminated metastases, and early death, detailing the results of somatic tumor profiling using next-generation sequencing (NGS). Case Series: The first case presented is a rare case of UC of the renal pelvis with osteosarcomatous differentiation and venous tumor thrombus in a 65-year-old man found to have a heterozygous germline variant of unknown significance in the neurofibromatosis-1 gene. The second case is a 72-year-old woman with sarcomatoid UC of the bladder. Herein, we discuss the presentation and clinical course, histology, immunohistochemical profiles, and somatic tumor testing results. We then review the literature regarding this rare and aggressive entity, detail options for optimal management, and address the role of molecular profiling in these cases. Conclusion: Sarcomatoid UC is a rare and aggressive entity. NGS may be useful in these cases to guide systemic therapy.
Keywords: Sarcomatoid, urothelial carcinoma, bladder cancer, renal mass, next-generation sequencing, green
