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Molecular and immunohistochemical characterization reveals novel BRAF mutations in metanephric adenoma #MMPMID25602792
Udager AM; Pan J; Magers MJ; Palapattu GS; Morgan TM; Montgomery JS; Weizer AZ; Hafez KS; Miller DC; Wolf JS; McHugh JB; Chinnaiyan AM; Dhanasekaran SM; Mehra R
Am J Surg Pathol 2015[Apr]; 39 (4): 549-57 PMID25602792show ga
Metanephric adenoma (MA) is a rare benign renal tumor comprised of a neoplastic proliferation of primitive metanephric tubular cells. A previous study identified BRAF V600E mutations in approximately 90% of MA and found that similar BRAF exon 15 mutations are exceedingly rare in other common renal tumors, including renal cell carcinoma (RCC) and oncocytoma. A recent follow-up study has validated mutation-specific immunohistochemistry (IHC) for detection of BRAF V600E mutations in a small cohort of MA. Here, we extend these findings to a larger, independent cohort of MA, demonstrating an overall 88% sensitivity and 100% specificity for BRAF V600E IHC. In addition, we report two cases of MA with novel BRAF exon 15 mutations, including a V600D missense mutation and a compound V600D and K601L missense mutation. Finally, we evaluate BRAF V600E IHC in a large TMA cohort of common renal tumors and find no significant expression in several RCC subtypes. These data support a role for BRAF V600E IHC in diagnostically challenging cases of MA and expand the spectrum of BRAF exon 15 mutations in this uncommon but unique renal neoplasm.