Lessons from histopathologic examination of nephrectomy specimens in patients with tuberous sclerosis complex: cysts, angiomyolipomas, and renal cell carcinoma

Renal manifestations in patients with tuberous sclerosis complex (TSC) include cysts, angio-myolipoma, and renal cell carcinoma. Unlike many hereditary predisposition syndromes, the spectrum of renal tumors in TSC patients (including both angiomyolipoma and renal cell carcinoma) is broad, with significant morphologic heterogeneity. An improved understanding of histopathologic findings in TSC patients and associated clinicopathologic correlates has significant implications not just in estab-lishing a diagnosis of TSC, but also in the recognition of sporadic tumors occurring secondary to so-matic alterations of TSC1/TSC2/MTOR pathway genes and accurate prognostication. In this review, we have discussed issues relevant to clinical management based on histopathologic findings in nephrec-tomy specimens from patients with TSC. This includes discussions related to screening for TSC, diag-nosis of PKD1/TSC2 contiguous gene deletion syndrome, the morphologic spectrum of angiomyolipoma and renal epithelium-derived neoplasia, including the risk of disease progression.(c) 2022 Elsevier Inc. All rights reserved.

Automated summary

Renal manifestations in patients with tuberous sclerosis complex (TSC) include cysts, angiomyolipoma, and renal cell carcinoma. Understanding histopathologic findings in TSC patients is crucial for diagnosis and prognostication.