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May 10, 2026International Journal of Surgical Pathology0 citations

Primary Renal Sclerosing Epithelioid Fibrosarcoma With EWSR1::CREB3L1 Fusion: A Diagnostic Pitfall With a Comprehensive Review of Reported Patients

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ANAyoub NahalJJJessica JahodaWHWaleed Hassen

Key Points

  • The aim is to accurately identify primary renal sclerosing epithelioid fibrosarcoma to avoid misdiagnosis with other renal neoplasms.
  • Radiologic evaluation and partial nephrectomy were performed followed by histological examination.
  • A comprehensive review of 19 documented patients with renal SEF was conducted.
  • MUC4 immunohistochemistry and molecular testing were utilized to aid in diagnosis.
  • The tumor displays unique histological features, including a densely sclerotic stroma and characteristic filigree collagen.
  • Accurate recognition is critical to differentiate it from sarcomatoid renal cell carcinoma and other similar tumors.
  • Data indicates a higher occurrence of renal SEF compared to other sites within the genitourinary tract.

Abstract

fusion. Radiologic evaluation revealed a solid renal mass suspicious for malignancy, prompting partial nephrectomy. Histologically, the tumor was composed of epithelioid and spindle cells embedded in a densely sclerotic stroma with characteristic filigree collagen. Accurate recognition of renal SEF is critical, as it may be misdiagnosed as sarcomatoid renal cell carcinoma, sclerosing clear cell sarcoma of the kidney, epithelioid angiomyolipoma, or other primary renal neoplasms. In addition, a comprehensive review of the literature was performed. Including recently reported tumors identified within molecularly characterized series, a total of 19 patients with primary renal SEF have been documented to date. Notably, within the genitourinary tract, available data suggest a relative predilection for renal involvement. This tumor confirms the broad anatomic spectrum of SEF and underscores the essential role of MUC4 immunohistochemistry and molecular testing in the evaluation of renal tumors with epithelioid cytology and prominent stromal sclerosis.

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Cite This Study

Nahal et al. (2026) studied this question.

synapsesocial.com/papers/6a0020cec8f74e3340f9ba9ahttps://doi.org/10.1177/10668969261444687
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