The radiology of sarcomas and sarcomatoid carcinomas of the kidney (original) (raw)
Related papers
Sarcoma of the Kidney: Report of 6 Cases
Urologia Journal, 1988
Primary renal sarcomas are rare and constitute about 3 % of all malignant renal neoplasms. They are malignant mesenchymal tumors of the kidney with a variety of histological types. In the past, these were variously classified as fibrosarcoma, leiomyosarcoma, angiosarcoma, liposarcoma, etc., but often they were also grouped under the common term sarcoma. As a result much confusion prevailed regarding the incidence of each of these entities. With recent advancements in histochemical techniques classification has been improved. We treated three cases of leiomyosarcoma and tree of fibrosarcoma. CLINICAL MATERIAL. The series included six cases of sarcomas seen at our division between 1973 and 1985. There were four women and two men. Patient age ranged from 38 to 74 years, with an average of 54 years. The right side was involved in 5 patients and the left side in one. IVP was performed in all cases, ultrasonography in four, CT scan in two and we required the use of selective arteriography in only one case. A definite diagnosis could not be made following these investigations. Retrospective immunohistochemical studies of neoplastic tissue fixed in formaline and set in paraffin were done to test the presence of cytocheratin, vimentin, desmin, and actin, in an attempt to identify the cell types of the neoplastic lesions. All patients underwent surgical treatment only. No radiotherapy or chemiotherapy was given. The cases histories are presented. CASES REPORT. Case 1. P.B.A. a 38-year old female, was admitted complaining of left flank pain of three weeks duration with spontaneous emission of a small-stone. She denied other symptoms. On physical examination she had pain during palpation of the abdomen, but no mass was found. Chest-X ray was negative. Laboratory findings (except for a urea level of 6,4 mg/dl; n. v.: 2,4-5,7 mg/dl) were within normal limits. IVP showed a soft tissue mass occupying the lower pole of the left kidney. The surgical specimen
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.
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 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.
Prognostic features of renal sarcomas (Review)
Oncology Letters, 2014
The aim of the present review was to evaluate the prognostic features of primary sarcomas of the kidney. A literature review was conducted using a number of databases, including Medline (PubMed) and Scopus, for studies published between January 1992 and December 2013. Of the studies published in English, those describing the prognostic features of primary sarcomas of the kidney were recorded. The electronic search was limited to the following keywords: Sarcoma, renal sarcoma, prognosis, diagnosis, immunohistochemistry, genetic and survey. Subsequent to the search, no review articles and/or meta-analyses associated with the prognosis of primary sarcomas of the kidney were identified. In total, 31 studies, which consisted of case studies, case series and studies concerned with the overall prognosis of urological soft-tissue sarcomas, were reviewed. Primary sarcoma of the kidney has a poor prognosis compared with other sarcomas of the urogenital system. In addition to the surgical excision of renal sarcomas, pathological, molecular and genetic prognostic factors are also considered. Due to the small number of cases, previous studies have not randomized the prognostic features of primary sarcomas of the kidney. The elucidation of the so-called 'chaotic' genetic and molecular basis of renal sarcomas will help to predict patient prognoses. Surgical excision is the most significant parameter for determining the prognosis of sarcomas of the kidney. However, sarcomas also exhibit prognostic features that are based upon pathological, genetic and molecular factors. The present review suggests that additional factors may be important in predicting the prognosis of patients with renal sarcomas, and that clinicians should plan treatment and follow-up regimens according to these factors. Contents
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.
Unusual benign solid neoplasms of the kidney: cross-sectional imaging findings
2016
Kidney neoplasms are common clinical disorders now being detected in even great-er numbers due to the widespread use of cross-sectional imaging. Benign kidney neoplasms, once thought to be highly unusual, are being diagnosed in ever increas-ing numbers. In one series, 16.1 % of patients who underwent partial nephrectomy for a presumed solitary renal cell carcinoma turned out to have a benign diagnosis in the final pathological analysis (1). Recent developments on computed tomography (CT) and mag-netic resonance imaging (MRI) have limited value in differentiation between benign and malignant renal masses. Diffusion MRI studies yielded significantly different apparent dif-fusion coefficient (ADC) values between benign and malignant renal masses. These studies mostly evaluated the different ADC values between oncocytoma/angiomyolipoma and re-nal cell carcinomas (2). The role of ADC values in differentiation between uncommon be-nign renal masses and malignant renal masses has not been w...
Open Journal of Pathology, 2013
Sarcomatoid carcinoma is a rare malignant tumor that has both malignant epithelial and mesenchymal components. We describe a sarcomatoid carcinoma arising in the right renal pelvis of a 68-year-old man. The dominant component of the tumor was osteosarcomatous, but there were also focal carcinomatous areas. The sarcomatous tumor cells produced abundant osteoid matrix surrounded by osteoblastic cells. The carcinomatous tumor cells consisted of papillary urothelial carcinoma. Immunohistochemical assay showed that the sarcomatous tumor cells were positive for vimentin and negative for cytokeratin. The papillary urothelial carcinoma was positive for cytokeratin and negative for vimentin. After surgery, the patient underwent adjuvant chemotherapy. Four months later, he presented with recurrence in the right subphrenic area and metastasis in the right middle lobe of the lung.