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Omiyale AO. Primary vascular tumours of the kidney. World J Clin Oncol 2021; 12:1157-1168. [PMID: 35070735 PMCID: PMC8716994 DOI: 10.5306/wjco.v12.i12.1157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/01/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
Primary vascular tumours of the kidney are rare and may pose diagnostic difficulties because of their similar clinical, morphological, and immunohistochemical features. This article summarizes the clinical and pathological features of primary renal angiosarcoma and anastomosing haemangioma of the kidney including epidemiology, genetics, and prognosis. Renal anastomosing haemangiomas are benign neoplasms characterized by anastomosing capillary-sized vascular channels. These tumours are rare, with about 75 cases reported in the literature. Most anastomosing haemangiomas are found incidentally on ultrasound, computed tomography, or magnetic resonance imaging. Common symptoms include abdominal pain, haematuria, and abdominal mass. Renal anastomosing haemangiomas are characterized by recurrent mutations in GNAQ and GNA14 genes. The prognosis of anastomosing haemangioma is excellent. Primary renal angiosarcomas are malignant tumours showing endothelial differentiation. To date, 76 cases have been described in the literature. Primary renal angiosarcomas are frequently symptomatic. The clinical features of renal angiosarcomas are similar to those of renal anastomosing haemangiomas, including abdominal pain, haematuria, and abdominal mass. Angiogenesis-related genes and vascular-specific receptor tyrosine kinases such as KDR, TIE1, SNRK, TEK, and FLT1 are upregulated in angiosarcomas. Primary renal angiosarcomas are highly aggressive neoplasms with a poor prognosis despite surgical treatment, chemotherapy, radiotherapy, or targeted therapy.
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Affiliation(s)
- Ayo O Omiyale
- Department of Cellular Pathology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, United Kingdom
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Kazaz IO, Ersoz S, Colak F, Teoman AS, Kazaz SN, Karaguzel E, Kutlu O. Primary renal angiosarcoma: A case report and a short review of literature. INDIAN J PATHOL MICR 2020; 63:S44-S46. [PMID: 32108626 DOI: 10.4103/ijpm.ijpm_66_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Primary renal angiosarcomas (AS) are uncommon tumors with poor prognosis. Aetiology is unknown but some unproven risk factors have been described. It is difficult to discriminate these masses from renal cell carcinomas or other renal masses with imaging modalities. Immunohistochemistry plays an important role in the diagnosis. Main treatment protocol for primary renal AS is still controversial and nephrectomy with chemotherapy and/or radiotherapy seems the only treatment option. We state a primary renal angiosarcoma case for its rareness and contribution to literature.
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Affiliation(s)
- Ilke Onur Kazaz
- Department of Urology and Pathology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Safak Ersoz
- Department of Urology and Pathology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Fatih Colak
- Department of Urology and Pathology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | | | - Seher Nazli Kazaz
- Department of Medical Oncology, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Ersagun Karaguzel
- Department of Urology and Pathology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Omer Kutlu
- Department of Urology, Akdeniz University Faculty of Medicine, Antalya, Turkey
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Boni A, Cochetti G, Sidoni A, Bellezza G, Lepri E, Giglio AD, Turco M, Vermandois JARD, Zingaro MD, Cirocchi R, Mearini E. Primary Angiosarcoma of the Kidney: Case Report and Comprehensive Literature Review. Open Med (Wars) 2019; 14:443-455. [PMID: 31410364 PMCID: PMC6689208 DOI: 10.1515/med-2019-0048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/24/2019] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Angiosarcoma (AS) is an aggressive malignant tumour of endothelial origin, most frequently compelling the skin. The kidney is a rare site of primary occurrence of AS with a quite challenging diagnosis and poor prognosis, mainly due to its raw metastasising power. We described our first case of AS treatment. A comprehensive literature review in this field is also carried out. PATIENTS AND METHODS We report the case of a 56-years-old man with radiological appearance of an 11 cm poor vascularised left renal mass. The pre-operative imaging ruled out distant metastases and inferior vena cava thrombosis. Thus, after radioembolization, we performed a transperitoneal open radical nephrectomy with regional lymphadenectomy with the removal of the middle portion of the ileo-psoas muscle, followed by two lines of adjuvant chemotherapy. We analysed all the papers concerning primary kidney AS until December 2018. RESULTS Estimated intraoperative blood loss was 200 mL with an operative time of 100 minutes. No postoperative complications were recorded, with the patient discharge in the 8th postoperative day. The pathological assessment showed a pT3a N0, M0 tumour compatible with AS of the kidney. An immune-histochemical study showed a vascular positive for CD31, CD34, Fli-1 with a Ki-67/Mib 1 of 50%. One month after surgery the patient began adjuvant chemotherapy with gemcitabine. After 45 days from surgery, a Computed Tomography scan showed lung and liver metastases with disease relapse in the left kidney lodge. The response to the first-line treatment was excellent, unlike the second-line, encountering a chemo-refractory disease. The cancer-specific survival was of 15 months. We included 66 cases in our review. CONCLUSION This is the first case of treatment of kidney AS performed at our Institute. Our findings added new information about the unclear biology and progression of this subset of tumours, demonstrating an abysmal prognosis.
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Affiliation(s)
- Andrea Boni
- Department of Surgical and Biomedical Sciences, Urologic Clinic, University of Perugia, University Hospital of Perugia, Perugia, Italy
| | - Giovanni Cochetti
- Department of Surgical and Biomedical Sciences, Urologic Clinic, University of Perugia, University Hospital of Perugia, Perugia, Italy
| | - Angelo Sidoni
- Department of Experimental Medicine, Section of Anatomic Pathology and Histology, Perugia Medical School, University of Perugia, Perugia, Italy
| | - Guido Bellezza
- Department of Experimental Medicine, Section of Anatomic Pathology and Histology, Perugia Medical School, University of Perugia, Perugia, Italy
| | - Emanuele Lepri
- Department of Surgical and Biomedical Sciences, Urologic Clinic, University of Perugia, University Hospital of Perugia, Perugia, Italy
| | - Andrea De Giglio
- Department of Experimental Medicine, Section of Oncology, University of Perugia, Perugia, Italy
| | - Morena Turco
- Department of Surgical and Biomedical Sciences, Urologic Clinic, University of Perugia - S.M. della Misericordia Hospital, P.le Menghini 1, 06132, Perugia, Italy
| | - Jacopo Adolfo Rossi De Vermandois
- Department of Surgical and Biomedical Sciences, Urologic Clinic, University of Perugia, University Hospital of Perugia, Perugia, Italy
| | - Michele Del Zingaro
- Department of Surgical and Biomedical Sciences, Urologic Clinic, University of Perugia, University Hospital of Perugia, Perugia, Italy
| | - Roberto Cirocchi
- Department of Surgical and Biomedical Sciences, Urologic Clinic, University of Perugia, University Hospital of Perugia, Perugia, Italy
| | - Ettore Mearini
- Department of Surgical and Biomedical Sciences, Urologic Clinic, University of Perugia, University Hospital of Perugia, Perugia, Italy
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Omiyale AO. Clinicopathological features of primary angiosarcoma of the kidney: a review of 62 cases. Transl Androl Urol 2016; 4:464-73. [PMID: 26816844 PMCID: PMC4708591 DOI: 10.3978/j.issn.2223-4683.2015.05.04] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Angiosarcoma (AS) is a malignant tumor occurring in less than 2% of soft tissue sarcomas. Primary involvement of the kidney is rare, its pathogenesis remains largely unknown and it has overlapping features with other tumors of the kidney. The objective of this paper is to review the case reports of primary AS of the kidney in the literature. The search terms were primary AS of the kidney, primary renal AS and primary renal hemangiosarcoma. The total cohort of the cases reviewed was 62. The mean age of presentation was 61 years old with a predilection for the male sex. Metastatic disease at the time of diagnosis accounted for 44.9% (22/49) of the cases reported and 44.4% (12/27) of patients with non-metastatic disease at diagnosis, subsequently developed metastasis. Primary AS of the kidney is a rare malignant tumor with a poor prognosis. Local recurrence and distant metastasis is common. Primary AS of the kidney shares similar clinical presentation with other renal tumors and imaging does not allow for tumor specific diagnosis. Histopathological examination and immunohistochemistry is very important for the confirmation of the diagnosis. Current treatment options include a variable combination of surgery, radiotherapy and chemotherapy.
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