<i>TFEB</i> -Amplified Renal Cell Carcinoma: Integrating Histopathologic and Molecular Diagnostics with Therapeutic Implications
Bibliographic record
Abstract
TFEB -amplified renal cell carcinoma (RCC) represents a newly described and rare aggressive molecular subtype of RCC that is characterized by TFEB gene amplification (6p21.1). These tumors are characterized by heterogeneous morphology (papillary, tubulocystic, and nested patterns), eosinophilic/clear cytoplasm, and prominent nucleoli with perinucleolar clearing. We present a diagnostically challenging lesion in a 72-year-old man who was found to have a 9.8 cm partially necrotic renal mass during work up for decreased renal function and hematuria. The nephrectomy specimen revealed a large tumor invading into the renal vein, renal sinus, and perinephric fat. Histology showed a heterogeneous tumor of clear or eosinophilic cells with prominent nucleoli and occasional perinucleolar clearing. Apically oriented nuclei were noted surrounding tubulocystic structures, as were several multinucleated tumor cells. Immunohistochemistry demonstrated Pan-keratin/Mel-A positivity. Notably, PAX8 was negative in the majority of the tumor and PD-L1 had a CPS of <5. Fluorescent in situ hybridization showed TFEB amplification (6-15 copies) and confirmed the diagnosis of TFEB -amplified RCC. Despite combined immunotherapy and anti-angiogenic therapy, the patient succumbed to rapid metastatic progression 5 months postoperatively, underscoring the tumor's aggressive behavior and current therapeutic limitations. This report outlines the diagnostic complexities associated with TFEB -amplified RCC and emphasizes the need for effective management strategies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".