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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1802633
Case Report with Review of Literature

ALK-Rearranged Renal Cell Carcinoma: A Case Report with Review of Literature

Authors

  • Gauri Deshpande

    1   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India

  • Amandeep Arora

    2   Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India

  • Aparna Katdare

    3   Department of Radiodiagnosis, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India

  • Gagan Prakash 

    2   Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India

  • Amit Joshi

    4   Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India

  • Vedang Murthy

    5   Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India

  • Sangeeta Desai 

    1   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India

  • Santosh Menon 

    1   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India

Funding None.
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Abstract

Anaplastic lymphoma kinase (ALK) rearranged renal cell carcinoma (RCC) is a newly recognized entity in the 2022 WHO classification under molecularly defined renal tumors. It is imperative to diagnose this entity, especially with the advent of ALK-directed therapy. Herein, we report the case of a 52-year-old lady who presented with incidentally detected mass in the mid-pole of the left kidney. The patient underwent left radical nephrectomy. Microscopically, the tumor showed varied patterns, namely, papillary, tubulocystic, solid, and varied cell morphologies—cuboidal cells with low-grade nuclei, and rhabdoid cells in nests and clusters. Locoregional spread to the lymph nodes was noted. The tumor was reported as “renal cell carcinoma, unclassified.” On further immunohistochemistry, the tumor was diffusely positive for ALK by immunohistochemistry. Further, the finding of ALK rearrangement was confirmed by fluorescence in situ hybridization, thus confirming the diagnosis of ALK-rearranged RCC. She came back with progression after a year and was started on ALK-directed therapy after confirmation of ALK rearrangement. However, she succumbed to the disease 15 months after diagnosis. ALK-directed therapy has revolutionized the management of ALK-positive lung adenocarcinomas. Although ALK-rearranged RCC is a rare subtype of RCC, it is essential to know this case histopathologically for an accurate diagnosis and future development of targeted therapy.

Keywords

ALK-rearranged renal cell carcinoma - histopathology - fluorescence in-situ - hybridization

Authors' Contributions

G.D. S.M. contributed to the concepts, design, definition of intellectual content, literature search, data acquisition, data analysis, manuscript preparation, manuscript editing, manuscript review, are served as guarantors. A.A., A.K., G.P., A.J., V.M. contributed to the concepts manuscript review, serve as guarantors. S.D. contributed to the concepts, manuscript preparation, manuscript editing, manuscript review, serve as a guarantor.


Patient Consent

The authors certify that they have obtained all appropriate patient consent forms from the patient. In the form, the patient has given written consent for images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.




Publication History

Article published online:
14 February 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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