Concurrent Angiomyolipoma and Renal Cell Neoplasia: A Study of 36 Cases

• Published in: Modern pathology 2001-03, Vol.14 (3), p.157-163
• Main Authors: Jimenez, Rafael E, Eble, John N, Reuter, Victor E, Epstein, Jonathan I, Folpe, Andrew L, de Peralta-Venturina, Mariza, Tamboli, Pheroze, Ansell, I David, Grignon, David J, Young, Robert H, Amin, Mahul B
• Format: Article
• Language: English
• Subjects: Adenoma, Oxyphilic - chemistry; Adenoma, Oxyphilic - pathology; Adenoma, Oxyphilic - surgery; Angiomyolipoma; Angiomyolipoma - chemistry; Angiomyolipoma - etiology; Angiomyolipoma - pathology; Angiomyolipoma - surgery; Antigens, Neoplasm; Cancer; Carcinoma, Renal Cell - chemistry; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - surgery; Clear cell carcinoma; Collision neoplasms; Female; Follow-Up Studies; Hospitals; Humans; Immunohistochemistry; Kidney; Kidney Neoplasms - chemistry; Kidney Neoplasms - etiology; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Laboratory Medicine; Male; Medicine; Medicine & Public Health; Melanoma-Specific Antigens; Middle Aged; Neoplasm Proteins - chemistry; Neoplasms, Multiple Primary - chemistry; Neoplasms, Multiple Primary - pathology; Neoplasms, Multiple Primary - surgery; Oncocytoma; original-article; Pathology; Patients; Renal cell carcinoma; Renal cell neoplasia; Tuberous Sclerosis - complications; Tuberous Sclerosis - pathology; Tumors
• ISSN: 0893-3952; 1530-0285
• DOI: 10.1038/modpathol.3880275

Little is known about the association of angiomyolipoma and adult renal-cell neoplasia. We studied the clinicopathologic features of 36 patients with concurrent angiomyolipoma and renal-cell neoplasia from the consultation and surgical pathology files of nine institutions. HMB-45 immunoreactivity was analyzed in both neoplasms. Twenty-five sporadic cases of patients with angiomyolipoma and renal-cell neoplasia and 11 cases of patients with tuberous sclerosis, as defined by Gomez' criteria, had mean ages of 59 and 53 years, respectively, and female–male ratios of 2:1 and 5:1, respectively. The mean size of the angiomyolipomas was 1 cm in the sporadic cases and 3 cm in those patients with tuberous sclerosis (medians: 0.5 and 3 cm, respectively, P =.002). The mean sizes of the renal-cell neoplasms were 5 cm in sporadic cases and 6 cm in patients with tuberous sclerosis (medians: 4 and 5 cm, respectively; P =.88). In both clinical settings, angiomyolipoma was more commonly the incidental tumor. Clear-cell (conventional) renal-cell carcinoma was the most common renal-cell neoplasm in both groups of patients, accounting for approximately two thirds of the tumors. In patients with tuberous sclerosis, 27% of renal-cell neoplasms were oncocytomas, compared with 8% in sporadic cases (P =.15). Papillary neoplasia, chromophobe, and collecting-duct renal-cell carcinoma were found only in sporadic cases. All of the 22 renal-cell neoplasms studied were negative for HMB-45, whereas all 25 angiomyolipomas studied were positive.