Hemangiopericytoma of kidney

Metastatic renal hemangiopericytoma: A rare case report

The hemangiopericytoma (HPC) of the kidney is extremely rare perivascular neoplasm. There are no specific radiological or clinical findings that can aid in preoperative diagnosis. In the world literature, only 41 cases of renal HPC have been previously documented. We report on a 56-year old woman with renal HPC of the right kidney who had lung metastasis at the time of diagnosis. The right radical nephrectomy was performed and the combination chemotherapy was given, postoperatively. After 3 cycles of chemotherapy, disease was stable, but progression was seen at the end of 6 courses of chemotherapy. The patient died due to progression of disease ten months later after the diagnosis. We suggested that for patients present with renal mass, renal HPC as well as the other renal tumors should be considered in the differential diagnosis.

A novel case of synovial sarcoma of the kidney: impact of SS18/SSX analysis of renal hemangiopericytoma-like tumors

We report a new case of synovial sarcoma of the kidney. The patient underwent nephrectomy because of a large tumor in the right kidney. The histologic diagnosis was hemangiopericytoma. Less than 1 year after primary surgery the patient was reoperated due to massive local recurrence. Histology now revealed a poorly differentiated tumor tissue with hemangiopericytoma-like features. Immunostainings showed immunoreactivity to cytokeratin, epithelial membrane antigen, and vimentin. The tumor was negative to CD34 and factor VIII. The tumor cell proliferation, assessed by Ki-67, was high. RT-PCR analysis and sequence analysis demonstrated the presence of SS18/SSX2 fusion gene. Review of the histologic specimens from the original tumors confirmed hemangiopericytoma-like morphology. The new diagnosis was poorly differentiated synovial sarcoma. At the time of reoperation, lung metastases were detected radiologically, reflecting a very aggressive phenotype. To our knowledge, this is the third case of poorly differentiated synovial sarcoma of the kidney. Common for all these three cases is the hemangiopericytoma-like histology and a very aggressive clinical behavior. These circumstances accentuate the impact of SS18/SSX analysis in diagnosis of renal hemangiopericytoma-like tumors.

Bilateral renal hemangiopericytoma

The first reported case of bilateral renal hemangiopericytoma is presented. The 19 previous renal hemangiopericytomas that have been reported in the world literature are reviewed. This lesion has afflicted patients ranging in age from sixteen to sixty-eight years (mean 41 years) with an equal sex distribution. Mortality from hemangiopericytoma of the kidney has been 50 percent, and the primary mode of therapy remains surgical.

Primary sarcomas of the kidney. A clinicopathologic and DNA flow cytometric study of 17 cases

Primary sarcomas of the kidney in adults are rare. In the handful of published reports of all soft tissue sarcomas, DNA ploidy has correlated with histologic grade and outcome. This report presents the clinicopathologic and flow cytometric features of 17 cases of primary renal sarcoma (seven men and ten women, ages 28-69 years). Presenting symptoms included abdominal and back pain and hematuria. Stages at diagnosis were I, in three patients; II, five patients; III, two patients; and IV, two patients. Eight tumors were leiomyosarcoma, two malignant fibrous histiocytoma, one hemangiopericytoma, one fibrosarcoma, and five unclassified. Tumors measured 5.5 to 23 cm, seven contained marked nuclear pleomorphism, seven were extensively necrotic, and mitotic rate was 1 to 33 per 10 high-power fields. Seven tumors showed aneuploidy and five were diploid. Thirteen patients were dead of disease after a mean of 23 months and two were alive with known metastases at 29 and 33 months, respectively. Ploidy pattern and outcome or time to death were not correlated, but aneuploidy correlated with histologic grade, marked nuclear pleomorphism (P less than 0.05), extensive necrosis (p less than 0.01), and high mitotic rate (0.05 less than P less than 0.10). The authors conclude that although DNA ploidy does correlate with histologic grade, for primary renal sarcomas, whose prognosis in this series was extremely poor, it does not correlate with outcome.

Aspiration cytology of hemangiopericytoma: a report on two cases

The cytological features of fine-needle aspiration in two cases of hemangiopericytoma are described. The diagnosis was confirmed by cell block and the silver impregnation method, demonstrating reticulin fibers on smears as well as on the cell block. Histopathological correlation was done in both cases.

Juxtaglomerular cell tumor with elevation of serum erythropoietin

Juxtaglomerular cell tumor of the kidney is an uncommon neoplastic cause of surgically curable hypertension. We report a case of erythrocytosis due to elevated serum erythropoietin with a renin secreting juxtaglomerular cell tumor.

Renal hemangiopericytoma: surgical, radiological and pathological implications

The first case of renal hemangiopericytoma presenting radiologically as a hypovascular mass is described. Preoperative diagnostic evaluation included ultrasonography, retrograde pyeloureterography, computerized tomography and angiography. Electron microscopy is helpful to distinguish this lesion from histologically similar juxtaglomerular cell tumors. Although renal hemangiopericytoma may appear benign on pathological examination it should be treated as a low grade malignancy and followed carefully.