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
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.
Authors
Correspondence to:
Sarah Psutka, Department of Urology, University of Washington, Seattle, WA spsutka@uw.edu
Publication history:
Received 21 Jan 2021
Revised 17 Mar 2021
Accepted 26 Jun 2021
Published online 12 Aug 2021
Published in print 28 Aug 2021
Hertz AM, Lerma LA, Ahn JS, Hagedorn JC, Konnick EQ, Bennett RL, Grivas P, Wagner MJ, Reder NP, Psutka SP. Two cases of aggressive sarcomatoid urothelial carcinoma reveal potential molecular targets. EJMCR. 2021; 5(8): 230-237. doi:
10.24911/ejmcr/173-1611205898
Hertz AM, Lerma LA, Ahn JS, Hagedorn JC, Konnick EQ, Bennett RL, Grivas P, Wagner MJ, Reder NP, Psutka SP. Two cases of aggressive sarcomatoid urothelial carcinoma reveal potential molecular targets. https://www.ejmcr.com/?mno=47540 [Access: May 04, 2024]. doi:
10.24911/ejmcr/173-1611205898
Hertz AM, Lerma LA, Ahn JS, Hagedorn JC, Konnick EQ, Bennett RL, Grivas P, Wagner MJ, Reder NP, Psutka SP. Two cases of aggressive sarcomatoid urothelial carcinoma reveal potential molecular targets. EJMCR. 2021; 5(8): 230-237. doi:
10.24911/ejmcr/173-1611205898
Hertz AM, Lerma LA, Ahn JS, Hagedorn JC, Konnick EQ, Bennett RL, Grivas P, Wagner MJ, Reder NP, Psutka SP. Two cases of aggressive sarcomatoid urothelial carcinoma reveal potential molecular targets. EJMCR. (2021), [cited May 04, 2024]; 5(8): 230-237. doi:
10.24911/ejmcr/173-1611205898
Hertz, A. M., Lerma, . L. A., Ahn, . J. S., Hagedorn, . J. C., Konnick, . E. Q., Bennett, . R. L., Grivas, . P., Wagner, . M. J., Reder, . N. P. & Psutka, . S. P. (2021) Two cases of aggressive sarcomatoid urothelial carcinoma reveal potential molecular targets. EJMCR, 5 (8), 230-237. doi:
10.24911/ejmcr/173-1611205898
Hertz, Alexandria M., L. Angelica Lerma, Justin S. Ahn, Judith C. Hagedorn, Eric Q. Konnick, Robin L. Bennett, Petros Grivas, Michael J. Wagner, Nicholas P. Reder, and Sarah P. Psutka. 2021. Two cases of aggressive sarcomatoid urothelial carcinoma reveal potential molecular targets. European Journal of Medical Case Reports, 5 (8), 230-237. doi:
10.24911/ejmcr/173-1611205898
Hertz, Alexandria M., L. Angelica Lerma, Justin S. Ahn, Judith C. Hagedorn, Eric Q. Konnick, Robin L. Bennett, Petros Grivas, Michael J. Wagner, Nicholas P. Reder, and Sarah P. Psutka. "Two cases of aggressive sarcomatoid urothelial carcinoma reveal potential molecular targets." European Journal of Medical Case Reports 5 (2021), 230-237. doi:
10.24911/ejmcr/173-1611205898
Hertz, Alexandria M., L. Angelica Lerma, Justin S. Ahn, Judith C. Hagedorn, Eric Q. Konnick, Robin L. Bennett, Petros Grivas, Michael J. Wagner, Nicholas P. Reder, and Sarah P. Psutka. "Two cases of aggressive sarcomatoid urothelial carcinoma reveal potential molecular targets." European Journal of Medical Case Reports 5.8 (2021), 230-237. Print. doi:
10.24911/ejmcr/173-1611205898
Hertz, A. M., Lerma, . L. A., Ahn, . J. S., Hagedorn, . J. C., Konnick, . E. Q., Bennett, . R. L., Grivas, . P., Wagner, . M. J., Reder, . N. P. & Psutka, . S. P. (2021) Two cases of aggressive sarcomatoid urothelial carcinoma reveal potential molecular targets. European Journal of Medical Case Reports, 5 (8), 230-237. doi:
10.24911/ejmcr/173-1611205898