Case report and review: A rare case of sarcomatoid renal cell carcinoma manifesting with supraclavicular lymph node metastasis (original) (raw)

Sarcomatoid renal cell carcinoma: Clinicopathologic. A study of 42 cases

Cancer, 1987

Forty-two cases of sarcomatoid renal cell carcinoma were reviewed clinicopathologically. Twenty-four patients were men, and 18 women; average age was 56.2 years (range, 30-81 years). Eight, 9, 13, and 12 cases were Stages I, 11,111, and IV, respectively. Three morphologic patterns of sarcomatoid components were identified: malignant fibrous histiocytomatous (26 cases), fibrosarcomatous (6 cases), and unclassified sarcomatoid (10 cases). Mitotic count, degree of pleomorphism, cellularity, and amount of tumor matrix in the sarcomatoid areas, and similar morphologic parameters in the carcinomatous component all failed to correlate with prognosis, as did tumor size and renal vein involvement by tumor. Clinicopathologic stage was a most significant prognostic factor, with a survival of 49.7 months for Stage I and 6.8 months for combined Stages 11,111, and IV. Tumor necrosis in the sarcomatoid area and proportion of sarcomatoid components were also poor prognostic factors. When these factors were compared to the stage, necrosis was an independent variable, however, proportion of sarcomatoid components was a poor prognostic indicator only for Stages I and 11.

Sarcomatoid Renal Cell Carcinoma: A Rare Case with Review of Literature

Scholars Journal of Medical Case Reports

Sarcomatoid renal cell carcinoma is a rare and highly lethal form of kidney tumor. It is characterised by extensive chromosomal rearrangements. These tumors show microscopic features similar to spindle cell sarcoma with high cellularity and cellular atypia. Majority of cases represent rumours with 100% sarcomatoid pattern and no recognizable epithelial element. We present a case of sarcomatoid renal cell carcinoma to highlight the clinical features and aggressive nature of this tumor.

Sarcomatoid RCC, a Highly Aggressive Subtype of Renal Cell Carcinoma

Global Journal of Pathology and Microbiology, 2013

Real cancer incidence is on the rise mostly due to the overuse of imaging modalities for unrelated reasons. However despite the diagnosis of more renal cancer cases in earlier stages renal cancer is still one of the more fatal malignancies. Another reason that partly accounts for this is the heterogeneity of renal tumors even within the major histologic type, Renal Cell Carcinoma (RCC). Here we will describe a case of a sarcomatoid type RCC that resulted in early postoperative mortality of a patient with a clinically organ-confined tumor. A discussion on the histologic subtypes of RCC and their clinical implications will follow.

A Rare Case of Sarcomatoid Renal Cell Carcinoma in a Young Adult Patient

Research and Reports in Urology

Background: Sarcomatoid differentiation is a rare condition that could present in different subtypes of renal cell carcinomas (RCCs) and is associated with a significantly poor prognosis. Sarcomatoid renal cell carcinoma (SRCC) patients are typically aged between 54 and 63, with a male-to-female ratio ranging from 1.3:1 to 2:1. Here, we report a case of SRCC in a 29-year-old female patient. Case Presentation: A 29-year-old female presented with left flank pain. A large lump was palpated on left flank and there was costovertebral angle tenderness. The lump was enlarged, and the patient also suffered from anemia. Abdominopelvic CT demonstrated solid mass with an internal gliosis in the left part of the renal cortex and the solid component was enhanced with contrast admission. Then, the patient underwent left radical nephrectomy with wide perirenal excision and paraaortic lymph nodes resection. Histopathological examination revealed SRCC with no lymphovascular invasion. Conclusion: The scarcity of data on SRCCs emphasizes the need for ongoing research into the biology, diagnostics, and effective treatment options for patients with this disease, as responses to conventional therapies have been disappointing, leaving patients with few options. Cytoreductive nephrectomy for SRCC patients with metastatic disease is debatable, although some research suggests resection at any stage in patients with good performance status. In this case, radical nephrectomy was performed and there was no evidence of metastasis.

Sarcomatoid renal cell carcinoma with scant carcinomtaous components

International Journal of Urology, 2000

A 30-year-old male underwent radical nephrectomy for a right renal tumor 15 cm in diameter. On microscopic examination of initial 17 sections, the tumor consisted of pleomorphic giant cells and spindle neoplastic cells. There was no carcinomatous component. Immunohistochemically, the neoplastic cells were negative for keratin and epithelial membrane antigen but positive for vimentin. The giant cells were also scatteringly, weakly positive for myoglobin. At that time a diagnosis of rhabdomyosarcoma of the kidney was made. However, further microscopic examination of another eight sections revealed small areas of clear cell-type renal cell carcinoma (RCC) which transited to sarcomatous components and led to a diagnosis of sarcomatoid RCC. The patient underwent three cycles of adjuvant chemotherapy. He has been free of the disease for 14 months after nephrectomy.

MRI findings of sarcomatoid renal cell carcinoma in nine cases

Clinical Imaging, 2011

Purpose: To assess the magnetic resonance imaging (MRI) features of a series of 9 cases of pathologically proven sarcomatoid renal cell carcinoma (SRCC). Methods: Two radiologists in consensus retrospectively reviewed a spectrum of MRI features of nine cases of SRCC imaged at our institution between 2003 and 2009. Results: SRCC had a mean diameter of 9.9 cm. All cases had an irregular or infiltrative morphology and demonstrated heterogeneous T2 signal intensity and enhancement. Internal necrosis was present in all cases, with four cases demonstrating N50% necrosis. Evidence of aggressive local behavior and/or distant spread was frequently observed. Conclusions: We have presented the largest case series to our knowledge of the MRI appearance of SRCC, with the lesions tending to appear as large heterogeneous masses with internal necrosis and evidence of aggressive local or distant behavior. However, these imaging features are non-specific, and histology remains necessary to establish the diagnosis.

Early-Stage Sarcomatoid Renal Cell Carcinoma: Multidetector CT Findings

Urologia Internationalis, 2009

reports in the English-language literature [6, 7]. We describe a case of an early-stage SRCC in an elderly woman. The role of multidetector CT (MDCT) and its contribution to the diagnosis are discussed. Case Report An asymptomatic 64-year-old woman was referred to the Urology Department for an incidentally discovered non-cystic right renal mass on sonographic examination. Laboratory analysis was unremarkable. The patient underwent multidetector CT examination of the abdomen on a 16-row CT scanner. A sharply demarcated, lower pole right renal mass originating from the renal parenchyma was found (fig. 1). The dimensions of the tumor were 50 ! 58 ! 55 mm. The lesion was of soft tissue density on the unenhanced scan and enhanced moderately and inhomogeneously after contrast material administration (fig. 1). There were no signs of perinephric invasion or metastatic disease. The right renal vein and the inferior vena cava were patent. Based on the MDCT images, renal malignancy was suggested and radical nephrectomy was followed. Histologically, the tumor showed predominantly malignant spindle cells, intermingled with rare papillary epithelial components (fig. 2). The diagnosis of an early-stage SRCC was made. The patient is now free of disease on follow-up CT examination, 18 months after the operation.