Literature Watch 2020

Literature Watch & News: Genitourinary Pathology (2020 Q1)

Renal Cancer

Recurrent KRAS mutations in papillary renal neoplasm with reverse polarity.

– Al-Obaidy KI et al. Modern Pathology. 2019 Sep 18. PMID: 31534204.

This study, senior authored by the late Dr. David Grignon, a giant in the field of genitourinary pathology, is another seminal work which characterizes the morphologic features and molecular underpinnings of a unique variant of papillary renal cell carcinoma.

“Renal Cell Carcinoma With Leiomyomatous Stroma” Harbor Somatic Mutations of TSC1, TSC2, MTOR, and/or ELOC (TCEB1): Clinicopathologic and Molecular Characterization of 18 Sporadic Tumors Supports a Distinct Entity.

Shah RB et al. American Journal of Surgical Pathology. 2019 Dec 31. PMID: 31850909.

– The authors of this study provide insight into the characterization of renal neoplasms that are morphologically enriched for the presence of leiomyomatous stroma, including underlying molecular alterations.

Bladder Cancer

BCG is extensively used for the management of non-muscle invasive bladder cancer. However, significant shortages are anticipated in the coming year.

This has been highlighted by the Bladder Cancer Advocacy Network (BCAN):

Prostate Cancer

When and How Should Active Surveillance for Prostate Cancer be De-Escalated?

Rajwa P et al. European Urology Focus. 2020.

– Herein, the authors review available evidence and guidelines addressing transitions from active to passive monitoring for patients with low-risk prostate cancer.

Reporting Practices and Resource Utilization in the Era of Intraductal Carcinoma of the Prostate: A Survey of Genitourinary Subspecialists.

Gandhi JS et al. American Journal of Surgical Pathology. 2019 Dec 23. PMID: 31876580.

– This report summarizes best practice recommendations related to diagnosis and reporting practices pertaining to intraductal carcinoma of the prostate.

Management of Patients with Advanced Prostate Cancer: Report of the Advanced Prostate Cancer Consensus Conference 2019.

Gillessen S et al. European Urology. 2020 Jan 27. PMID: 32001144.

– This study summarizes expert opinion related to common issues and controversies regarding the management of patients with advanced prostate cancer, including metastatic hormone-sensitive and metastatic castration-resistant prostate cancer.

Literature Watch & News: Genitourinary Pathology (April 2020- Lockdown edition)

Sounak Gupta, MBBS, PhD and Rohit Mehra, MD.

Renal Cancer

MiT family translocation renal cell carcinoma.

Argani P. Semin Diagn Pathol. 2015 Mar;32(2):103-13. Review. PMID: 25758327.

– This review, authored by Dr. Pedram Argani, highlights the morphologic, translational and biologic features of MiT family aberration renal cell carcinoma.

Contemporary Renal Tumor Categorization With Biomarker and Translational Updates: A Practical Review.

Taylor et al. Arch Pathol Lab Med. 2019 Dec;143(12):1477-1491. Review. PMID: 31765248.

– The authors of this study provide insight into the evolutionary biomarker landscape of renal cell carcinoma, incorporating established markers with upcoming markers of clinical potential.

Bladder Cancer

Updates on the Genomics of Bladder Cancer and Novel Molecular Taxonomy.

Al-Ahmadie H, Netto GJ. Adv Anat Pathol. 2020 Jan;27(1):36-43. Review. PMID: 31743118.

This review provides an update on the recent advances in the molecular characterization and novel molecular taxonomy of urothelial carcinoma and its histologic variants.

Prostate Cancer

Knowing what’s growing: Why ductal and intraductal prostate cancer matter.

Lawrence et al. Sci Transl Med. 2020 Mar 4;12(533). Review. PMID: 32132214.

– This review summarizes the pathologic, clinical and translational implications of ductal prostate cancer and intraductal prostate cancer.

Towards precision oncology in advanced prostate cancer. Ku et al. Nat Rev Urol. 2019 Nov;16(11):645-654. Review. PMID: 31591549.

This review summarizes expert opinion related to concepts, common management issues and clinical applications for patients with advanced prostate cancer.

Testis Cancer

Recently Described and Clinically Important Entities in Testis Tumors: A Selective Review of Changes Incorporated Into the 2016 Classification of the World Health Organization.

Ulbright TM. Arch Pathol Lab Med. 2019 Jun;143(6):711-721. Review. PMID: 29949388.

– This review summarizes some common testicular pathologies with their clinical implications especially in light of the WHO classification of genitourinary tumors.

Penile Cancer

Pathology of Invasive and Intraepithelial Penile Neoplasia.

Canete-Portillo et al. Eur Urol Focus. 2019 Sep;5(5):713-717. Review. PMID: 31288989.

– This review summarizes an updated approach towards classification of penile intraepithelial neoplasia and penile invasive carcinoma.


Next generation immunohistochemistry: Emerging substitutes to genetic testing?

Andrici et al. Semin Diagn Pathol. 2018 May;35(3):161-169. Review.

PMID: 28662997

– This review elaborates on the utility of immunohistochemistry in detection of syndromic neoplasia (including genitourinary) from a surgical pathology perspective.

Complimentary Courses

USCAP: Urologic Pathology, Course Director: Adeboye O. Osunkoya, MD
Code: USCAPnvzcxw
“Complimentary Access to eLearning from USCAP

In response to the impact of the COVID-19 pandemic on pathology education, USCAP is currently providing complimentary access to eLearning modules

This includes a section on Urologic Pathology, a course that is directed by Dr. Adeboye O. Osunkoya, MD, and includes sections on high yield prostate and bladder pathology (code: USCAPnvzcxw).”

Literature Watch & News: Genitourinary Pathology (July 2020)

Sounak Gupta, MBBS, PhD and Rohit Mehra, MD.

Renal Cancer

ALK Rearranged Renal Cell Carcinoma (ALK-RCC): A Multi-Institutional Study of Twelve Cases With Identification of Novel Partner Genes CLIP1, KIF5B and KIAA1217.

Kuroda et al. Mod Pathol. 2020 May 28. PMID: 32467651

– This study describes the clinicopathologic features of a series of 12 ALK rearranged renal cell carcinomas, including diverse morphologic features, and advocates for ALK immunohistochemistry-based screening of “unclassifiable RCCs”.

Next-generation RNA Sequencing-based Biomarker Characterization of Chromophobe Renal Cell Carcinoma and Related Oncocytic Neoplasms.

Skala et al. Eur Urol. 2020 Jul;78(1):63-74. PMID: 32299640

– Herein, the authors evaluated RNA sequencing data from The Cancer Genome Atlas project to identify chromophobe renal cell carcinoma-specific biomarkers such as FOXI1, which are found to be localized to the intercalated cells of the distal nephron in non-neoplastic kidney tissue.

Bladder Cancer

European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: 2020 Update.

Roupret et al. Eur Urol. 2020 Jun 24;S0302-2838(20)30427-9. PMID: 32593530

This manuscript summarizes the recommendations of the European Association of Urology (EAU) Guidelines Panel on current evidence-based management of Upper Urinary Tract Urothelial Carcinoma (UTUC) for routine clinical practice.

Variant Morphology and Random Chromosomal Integration of BK Polyomavirus in Posttransplant Urothelial Carcinomas.

Bertz et al. Mod Pathol. 2020 Jul;33(7):1433-1442. PMID: 32047230

– Herein, the authors have studied the pathogenic role of BK polyoma virus in the development of urothelial carcinoma following immune suppression in solid organ transplant recipients.

Prostate Cancer

The 2019 Genitourinary Pathology Society (GUPS) White Paper on Contemporary Grading of Prostate Cancer.

Epstein et al. Arch Pathol Lab Med . 2020 Jun 26. PMID: 32589068

– This manuscript summarizes the Genitourinary Pathology Society (GUPS) recommendations pertaining to contemporary grading of prostate cancer based on a critical review of the literature along with pathology and clinician surveys.

The 2019 International Society of Urological Pathology (ISUP) Consensus Conference on Grading of Prostatic Carcinoma.

Van Leenders et al. Am J Surg Pathol. 2020 May 26. PMID: 32459716

This manuscript summarizes the International Society of Urological Pathology (ISUP) recommendations pertaining to contemporary grading of prostate cancer.

Role of Changes in Magnetic Resonance Imaging or Clinical Stage in Evaluation of Disease Progression for Men with Prostate Cancer on Active Surveillance.

Chestnut et al. Eur Urol. 2020 Apr;77(4):501-507. PMID: 31874726

Herein, the authors compare active surveillance protocols based on MRI or clinical stage changes compared with scheduled systematic biopsies to detect reclassification to grade group ≥2 disease.

Testis Cancer

Appendageal Tumors and Tumor-Like Lesions of the Testis and Paratestis: A 32-Years of Experience at a Single Institution.

l-Obaidy et al. Human Pathology, 2020 June 30; Electronic publication, ahead of print). PMID: 32619438

– This report summarizes a single institution experience of over 30 years pertaining to paratesticular tumors and tumors of testicular appendages.

Bilateral Synchronous Testicular Germ Cell Tumors in Children: Case Report and Review of the Literature.

Kebudi et al. Urology. 2020 Jun;140:155-158. PMID: 32199873

– This report highlights a case and summarizes relevant literature pertaining to bilateral testicular tumors in pediatric patients.

Penile Cancer

The Molecular Pathogenesis of Penile Carcinoma-Current Developments and Understanding.

Emmanuel et al. Virchows Arch. 2019 Oct;475(4):397-405. PMID: 31243533

– This review summarizes the literature pertaining to molecular drivers that govern penile carcinogenesis and their underlying prognostic and therapeutic importance.

A Modified Histopathologic Staging in Penile Squamous Cell Carcinoma Predicts Nodal Metastasis and Outcome Better Than the Current AJCC Staging.

Sali et al. Am J Surg Pathol. 2020 Apr 14. PMID: 32301753

– Herein, the authors have reviewed 142 cases of penile squamous cell carcinoma. This study evaluates the current AJCC staging system and suggests proposed modifications.


Prioritizing Urological Surgery in the COVID-19 Era: A Global Reflection on Guidelines.

Gravas et al. Eur Urol Focus. 2020 Jun 15;S2405-4569(20)30164-4. PMID: 32571743

– This report evaluates the prioritization and management of urological procedures during the COVID-19 pandemic.

The Multifaceted Long-Term Effects of the COVID-19 Pandemic on Urology.

Morlacco et al. Nat Rev Urol. 2020 Jul;17(7):365-367. PMID: 32377015

This review aims to discuss COVID related effects for patients and Urology.

Literature Watch & News: Genitourinary Pathology (October 2020)

Sounak Gupta, MBBS, PhD and Rohit Mehra, MD

Renal Cancer

Adverse histology, homozygous loss of CDKN2A/B, and complex genomic alterations in locally advanced/metastatic renal mucinous tubular and spindle cell carcinoma.

Yang et al. Mod Pathol. 2020 Sep 2. [Online ahead of print]. PMID: 32879414

MET alterations in biphasic squamoid alveolar papillary renal cell carcinomas and clinicopathological features.

Denize et al. Mod Pathol. 2020 Aug 7. [Online ahead of print]. PMID: 32770124

Distinguishing Benign Renal Tumors with an Oncocytic Gene Expression (ONEX) Classifier.

McGillivray et al. Eur Urol. 2020 Sep 21;S0302-2838(20)30709-0.[Online ahead of print]. PMID:  32972793

Bladder Cancer

Primary Female Urethral Carcinoma: Proposed Staging Modifications Based on Assessment of Female Urethral Histology and Analysis of a Large Series of Female Urethral Carcinomas.

Aron et al. Am J Surg Pathol. 2020 Aug 28. [Online ahead of print]. PMID:  32868524


Clear Cell Adenocarcinoma in Men: A Series of 15 Cases.

Grosser et al. Am J Surg Pathol. 2020 Sep 21. [Online ahead of print]. PMID:  32960833 

Intestinal metaplasia of the urinary tract harbors potentially oncogenic genetic variants.

Acosta et al. Mod Pathol. 2020 Aug 28. [Online ahead of print]. PMID:  32860003

Prostate Cancer

Clinicopathologic Study of Gleason Pattern 5 Prostatic Adenocarcinoma With “Single-cell” Growth Reveals 2 Distinct Types, One With “Plasmacytoid” Features.

Nguyen et al. Am J Surg Pathol. 2020 Sep 25. [Online ahead of print]. PMID:  32991340

PIN‐like ductal carcinoma of the prostate has frequent activating RAS/RAF mutations.

Kaur et al. Histopathology. 2020 Aug 2.  [Online ahead of print].  PMID:  32740981

Head to head: should the intraductal component of invasive prostate cancer be graded?

Varma and Epstein. Histopathology. 2020 Jul 21.  [Online ahead of print]. PMID:  32692448 

Testis Cancer

Hepatoid Teratoma, Hepatoid Yolk Sac Tumor, and Hepatocellular Carcinoma: A Morphologic and Immunohistochemical Study of 30 Cases.,_Hepatoid_Yolk_Sac_Tumor,_and.97346.aspx

Al-Obaidy et al. Am J Surg Pathol. 2020 Sep 25. [Online ahead of print]. PMID:  32991342

The detection of isochromosome i[12p] in malignant germ cell tumours and tumours with somatic malignant transformation using qPCR.

Fichtner et al. Histopathology. 2020 Sep 24.  [Online ahead of print].  PMID:  32970854

Penile Cancer

Peyronie disease: a clinicopathologic study of 71 cases with emphasis on histopathologic patterns and prevalent metaplastic ossification.

Hatfield et al. Hum Pathol. 2020 Jul 15;104:9-17. PMID: 32681945


The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future.

Wallis et al. Eur Urol. 2020 Sep 3;S0302-2838(20)30676-X. [Online ahead of print]. PMID: 32893062