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[Molecularly defined renal cell carcinomas].

Pathologie (Heidelb)

January 2025

Institut für Pathologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 8-10, 91054, Erlangen, Deutschland.

Background: The latest edition of the WHO classification of urinary and male genital tumours was published in 2022. The revision was based on the newest scientific literature. This article summarizes the updated recommendations regarding the classification of molecularly defined tumours.

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Article Synopsis
  • - Recent advancements in ccRCC treatment contrast with the limited research and improvements in non-clear cell renal cell carcinoma (nccRCC) therapies, highlighting a gap in understanding these cancer types.
  • - The 2022 WHO classification has redefined key nccRCC subtypes and introduced a molecular classification, which paves the way for better profiling and targeted therapies.
  • - The study reviews genomic alterations in nccRCC that could inform treatment options and emphasizes the need for personalized medicine due to the diverse nature of these cancers, as well as ongoing clinical trials for further insights.
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Morphological features are critical in evaluation of renal tumors and directing molecular workup. The objective of this study was to review histomorphology of renal tumors with molecular alterations of known subtypes. Renal tumors in The Cancer Genome Atlas were reviewed to identify tumors with defining molecular alterations.

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The first categorization for renal tumours was made by the WHO in 1981 and included only renal cell carcinoma (RCC). After that, classification was continuously altered over five decades. The WHO 2022 Classification of Urinary and Male Genital Tumours 2022 (5 edition) is molecular-driven and contains major revisions compared to the earlier classification from 2016.

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