Virchows Archiv

, Volume 473, Issue 1, pp 85–93 | Cite as

Predominantly cystic clear cell renal cell carcinoma and multilocular cystic renal neoplasm of low malignant potential form a low-grade spectrum

  • Maria Tretiakova
  • Vikas Mehta
  • Masha Kocherginsky
  • Agata Minor
  • Steven S. Shen
  • Sahussapont Joseph Sirintrapun
  • Jorge L. Yao
  • Isabel Alvarado-Cabrero
  • Tatjana Antic
  • Scott E. Eggener
  • Maria M. Picken
  • Gladell P. Paner
Original Article


Multilocular cystic renal cell carcinoma has been recently excluded from clear cell renal cell carcinoma (CCRCC) category and re-designated as multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) due to its uniformly good outcomes. While strict distinction between MCRNLMP from predominantly cystic CCRCC (pc-CCRCC) is being emphasized, the significance of extensive true cystic component in CCRCC has not been investigated. Herein, we analyzed 57 MCRNLMP, 69 pc-CCRCC, and 46 non-cystic CCRCC. There were no statistically significant differences between the three subtypes in age, gender, and laterality. ISUP grades were 1 (73%) or 2 (27%) for MCRNLMP; for pc-CCRCC were 1 (31%), 2 (60%), and 3 (9%); and for non-cystic CCRCC were 1 (9%), 2 (52%), 3 (26%), and 4 (13%). MCRNLMP were either pT stage 1 (91%) or 2 (9%), pT stages for pc-CCRCC were 1 (92.5%), 2 (1.5%), and 3 (6%) and for non-cystic CCRCC were 1 (58.7%), 2 (6.5%), and 3 (34.8%). None of MCRNLMP patients developed recurrences or metastases, and only 1 contralateral kidney tumor and 1 metastasis developed in pc-CCRCC. In contrast, 19 patients with non-cystic CCRCC developed metastases (5-year PFS 58%, CI 38.3–73.5%), and 1 patient died of disease. Monosomy 3 was common in both MCRNLMP (3/3) and pc-CCRCC (6/7). This large series of MCRNLMP confirms its indolent behavior, shows that pc-CCRCC has significantly better prognosis than non-cystic CCRCC and may define the lower grade spectrum of CCRCC. We recommend that the presence and extent of CCRCC cystic component should be documented in the pathology report.


Renal Cystic Clear cell Neoplasm Multilocular Carcinoma 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

428_2018_2371_MOESM1_ESM.doc (35 kb)
ESM 1 (DOC 35 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Maria Tretiakova
    • 1
  • Vikas Mehta
    • 2
  • Masha Kocherginsky
    • 3
  • Agata Minor
    • 4
  • Steven S. Shen
    • 5
  • Sahussapont Joseph Sirintrapun
    • 6
  • Jorge L. Yao
    • 7
  • Isabel Alvarado-Cabrero
    • 8
  • Tatjana Antic
    • 4
  • Scott E. Eggener
    • 9
  • Maria M. Picken
    • 2
  • Gladell P. Paner
    • 4
    • 9
  1. 1.Department of PathologyUniversity of Washington School of MedicineSeattleUSA
  2. 2.Department of Pathology and Laboratory MedicineLoyola University Medical CenterMaywoodUSA
  3. 3.Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  4. 4.Department of PathologyUniversity of ChicagoChicagoUSA
  5. 5.Department of PathologyMethodist HospitalHoustonUSA
  6. 6.Department of PathologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  7. 7.Pathline/Emerge LaboratoriesRamseyUSA
  8. 8.Department of Pathology, Mexican Oncology HospitalIMSSMexico CityMexico
  9. 9.Department of Surgery, Section of UrologyUniversity of ChicagoChicagoUSA

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