Review of hereditary leiomyomatosis renal cell carcinoma with focus on clinical and pathobiological aspects of renal tumors

Pol J Pathol. 2017;68(4):284-290. doi: 10.5114/pjp.2017.73920.


The entity of hereditary leiomyomatosis renal cell carcinoma (HLRCC)-associated RCC has been proposed and integrated into the recent International Society of Urologic Pathology (ISUP) of renal tumors. This tumor is characterized by presence of cutaneous and/or uterine leiomyomas and RCC and autosomal dominant hereditary form. Grossly, HLRCC arising in the kidney show the solid tumor with frequent partial cystic area. Microscopically, the tumor typically shows papillary RCC, type 2, with eosinophilic large nucleoli reminiscent of cytomegaloviral inclusion and perinuclear clearing/haloes. Immunohistochemically, tumor cells show the overexpression for 2SC and reduced expression of FH. Germline mutation of fumarate hydratase (FH) gene, the HLRCC responsible gene mapped to chromosome 1q43, has been identified in patients with HLRCC. As the renal cancer in patients with HLRCC generally behave aggressively even in a small size, complete surgical resection and retroperitoneal lymph node resection should be performed promptly when the tumor is discovered. The surveillance of renal tumor in FH gene germline mutation-positive patients should be started from the early age using ultrasound sonography or magnetic resonance imaging.

Keywords: pathology; review; Hereditary leiomyomatosis renal cell carcinoma.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / genetics
  • Biopsy
  • Carcinoma, Renal Cell / chemistry
  • Carcinoma, Renal Cell / genetics
  • Carcinoma, Renal Cell / pathology*
  • Carcinoma, Renal Cell / surgery
  • DNA Mutational Analysis
  • Diagnosis, Differential
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Immunohistochemistry
  • Kidney Neoplasms / chemistry
  • Kidney Neoplasms / genetics
  • Kidney Neoplasms / pathology*
  • Kidney Neoplasms / surgery
  • Leiomyomatosis / chemistry
  • Leiomyomatosis / genetics
  • Leiomyomatosis / pathology*
  • Leiomyomatosis / surgery
  • Male
  • Mutation
  • Neoplastic Syndromes, Hereditary / genetics
  • Neoplastic Syndromes, Hereditary / pathology*
  • Neoplastic Syndromes, Hereditary / surgery
  • Phenotype
  • Predictive Value of Tests
  • Skin Neoplasms / chemistry
  • Skin Neoplasms / genetics
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery
  • Treatment Outcome
  • Uterine Neoplasms / chemistry
  • Uterine Neoplasms / genetics
  • Uterine Neoplasms / pathology*
  • Uterine Neoplasms / surgery


  • Biomarkers, Tumor

Supplementary concepts

  • Hereditary leiomyomatosis and renal cell cancer