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Adeniran AJ, Shuch B, Humphrey PA. Sarcomatoid and Rhabdoid Renal Cell Carcinoma: Clinical, Pathologic, and Molecular Genetic Features. Am J Surg Pathol 2024; 48:e65-e88. [PMID: 38736105 DOI: 10.1097/pas.0000000000002233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Renal cell carcinoma (RCC) with sarcomatoid and rhabdoid morphologies has an aggressive biological behavior and a typically poor prognosis. The current 2022 WHO classification of renal tumors does not include them as distinct histologic entities but rather as transformational changes that may arise in a background of various distinct histologic types of RCC. The sarcomatoid component shows malignant spindle cells that may grow as intersecting fascicles, which is reminiscent of pleomorphic undifferentiated sarcoma. The rhabdoid cells are epithelioid cells with eccentrically located vesicular nuclei with prominent nucleoli and large intracytoplasmic eosinophilic inclusions. Studies have shown that RCCs with sarcomatoid and rhabdoid differentiation have distinctive molecular features. Sarcomatoid RCC harbors shared genomic alterations in carcinomatous and rhabdoid components, but also enrichment of specific genomic alterations in the sarcomatoid element, suggesting molecular pathways for development of sarcomatoid growth from a common clonal ancestor. Rhabdoid differentiation also arises through clonal evolution although less is known of specific genomic alterations in rhabdoid cells. Historically, treatment has lacked efficacy, although recently immunotherapy with PD-1/PD-L1/CTLA-4 inhibitors has produced significant clinical responses. Reporting of sarcomatoid and rhabdoid features in renal cell carcinoma is required by the College of American Pathologists and the International Collaboration on Cancer Reporting. This manuscript reviews the clinical, pathologic, and molecular features of sarcomatoid RCC and rhabdoid RCC with emphasis on the morphologic features of these tumors, significance of diagnostic recognition, the molecular mechanisms of tumorigenesis and differentiation along sarcomatoid and rhabdoid lines, and advances in treatment, particularly immunotherapy.
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Affiliation(s)
| | - Brian Shuch
- Department of Urology, University of California Los Angeles, Los Angeles, CA
| | - Peter A Humphrey
- Department of Pathology, Yale University School of Medicine, New Haven, CT
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Popov H, Petkova L, Stoyanov GS. Spindle Cell Renal Neoplasms: A Pathological Case Report on Primary Renal Leiomyosarcoma and Sarcomatoid Renal Cell Carcinoma. Cureus 2023; 15:e46449. [PMID: 37927619 PMCID: PMC10623498 DOI: 10.7759/cureus.46449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Renal oncopathology in adults, as a field of pathology, is dominated by a single entity - clear cell renal cell carcinoma (RCC) with other entries, such as urothelial carcinoma of the renal pelvis, angiosarcoma, and others being extremely rare. Herein, we report two histopathological cases with differential diagnoses of spindle cell renal neoplasms. The first patient, a 42-year-old male, presented with new-onset right-sided abdominal flank pain, and imaging showed a 12 cm renal tumor. Histopathology showed a spindle cell neoplasm, with significant mitotic activity and giant cell, with immunohistochemistry being positive for caldesmon and vimentin, focally for smooth muscle actin (SMA). No reaction was noted for pan-cytokeratin (CK AE1/AE3), epithelial membrane antigen (EMA), cytokeratin (CK) 7, cluster of differentiation (CD) 117, soluble 100 protein (S100), human melanoma black (HMB) 45, Melan A, CD10, and desmin. Due to peculiar histomorphology and the immunophenotype, the tumor was interpreted as primary renal leiomyosarcoma. Due to continuous outpatient consultations, treatment initiation was delayed, and three months later, the patient had already developed an 87 mm local recurrence and liver metastasis. The second patient, a 53-year-old male, presented to our institution for consultation of an already excised renal tumor, diagnosed as an incidental finding on a prophylactic abdominal ultrasound. The tumor presented for consultation histologically grew as intertwining bundles of spindle cells with polymorphic hyperchromic nuclei with prominent nucleoli and had extensive areas with necrosis. Immunohistochemically, the tumor diffusely expressed CK AE1/AE3 and caldesmon and had a patchy reaction for EMA and CD10. The SMA, desmin, CD117, and CK7 reactions were negative; hence, the tumor was interpreted as a spindle cell variety (sub-type) of clear RCC.
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Affiliation(s)
- Hristo Popov
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
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Poombal F, Ahsan M, Noor R, Nasir S, Khan A. Renal Leiomyosarcoma: Unraveling the Mysteries of a Rare Malignancy. Cureus 2023; 15:e45476. [PMID: 37859906 PMCID: PMC10583859 DOI: 10.7759/cureus.45476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
Primary leiomyosarcoma is a rare malignant kidney tumor. The diagnosis of this disease is usually made on the basis of histological examination because it lacks specific clinical or radiological characteristics. Differentiation between leiomyosarcoma and sarcomatoid renal cell carcinoma can be challenging because spindle cell morphology is observed in both tumors. Therefore, caution should be exercised when making a diagnosis of primary renal leiomyosarcoma. Both renal sarcoma and sarcomatoid renal cell carcinoma have a worse prognosis, and nephrectomy is the treatment of choice in locally resectable tumors. An example of such a tumor is discussed in relation to its diagnostic challenges. We report a case of a 35-year-old female who presented with a left renal mass. A left radical nephrectomy was performed, and a firm, tan-white, lobulated tumor (14x8x7.5 cm) was present on gross examination. A histological diagnosis of high-grade leiomyosarcoma was made on the basis of histology, positivity for caldesmon and desmin, and negative cytokeratin immunostaining. Sarcomatoid renal cell carcinoma was ruled out based on morphological findings after extensive sampling of the tumor along with negativity for CK, CD-10, and carbonic anhydrase IX immunostaining.
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Affiliation(s)
- Fnu Poombal
- Pathology, Nishtar Medical University, Multan, PAK
| | - Muhammad Ahsan
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
| | - Rida Noor
- Pathology, Faisalabad Medical University, Faisalabad, PAK
| | - Saira Nasir
- Pathology, Chughtai Institute of Pathology, Lahore, PAK
| | - Anam Khan
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
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Huang W, Chao F, Zhang Y, Li L, Gao Y, Qiu Y, Gao J, Kang L. Primary renal myxoid liposarcoma with pancreatic invasion on 18F-FDG PET/CT: first case report and literature review. Front Med (Lausanne) 2023; 10:1235843. [PMID: 37575998 PMCID: PMC10413121 DOI: 10.3389/fmed.2023.1235843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/14/2023] [Indexed: 08/15/2023] Open
Abstract
Background Myxoid liposarcoma (MLS) is a rare malignant soft tissue sarcoma that predominantly manifests in the deep soft tissues of the extremities, particularly within the musculature of the thigh. Unlike other types of liposarcoma, MLS demonstrates a propensity for metastasis to atypical sites, including the lung parenchyma, soft tissues, retroperitoneum, mediastinum, breast, liver, thymus, lymph nodes, and bones. The definitive diagnosis primarily relies on histology with HE staining. Imaging modalities such as ultrasound, CT, MRI, and 18F-FDG PET/CT scans serve as valuable tools for tumor identification. Case report A 57-year-old man presented with symptoms of abdominal distention and vomiting 1 month ago. Contrast-enhancement CT revealed a heterogeneous hypodense mass in the upper-middle part of the left kidney, displaying irregular morphology and protrusion towards the exterior of the kidney, with abundant blood supply and had a maximum dimension of approximately 10.7 cm × 9.0 cm. Additionally, a rounded soft tissue density was identified in the pancreatic body. Multiplanar reconstruction demonstrated a connection between the pancreatic lesion and the kidney mass. 18F-FDG PET/CT was conducted for staging, revealing significant growth of the lesion in the upper-middle part of the left kidney, extending beyond the kidney and infiltrating the pancreatic body. The lesion demonstrated remarkably high 18F-FDG uptake (SUVmax = 10.2, MTV = 136.13 cm3, TLG = 484.62). The postoperative pathological examination confirmed the diagnosis of MLS. On the 10th day post-surgery, the patient presented with tumor recurrence and underwent another surgical resection. Unfortunately, during the operation, the patient experienced a sudden cardiac arrest and died. Conclusion Renal MLS with invasion into the pancreas is very rare in clinical practice. Due to the limited research on the utilization of 18F-FDG PET/CT in this particular context, given the rarity and low incidence of MLS, its role remains largely unexplored. As PET/CT imaging becomes increasingly prevalent, thorough imaging of disease sites becomes indispensable for the development of treatment protocols and the monitoring of treatment response.
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Affiliation(s)
- Wenpeng Huang
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, China
| | - Fangfang Chao
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yongbai Zhang
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, China
| | - Liming Li
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Gao
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, China
| | - Yongkang Qiu
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, China
| | - Jianbo Gao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lei Kang
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, China
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Konno M, Osawa T, Hotta K, Shimizu A, Abe T, Matsumoto R, Kikuchi H, Shinohara N. Primary renal leiomyosarcoma with a tumor thrombus in the inferior vena cava. IJU Case Rep 2022; 5:66-69. [PMID: 35005478 PMCID: PMC8720715 DOI: 10.1002/iju5.12396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/01/2021] [Accepted: 10/21/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION We report a rare case of primary renal leiomyosarcoma with a tumor thrombus in the inferior vena cava. CASE PRESENTATION A 54-year-old woman presented with right flank pain and abdominal distension. Physical examination findings were unremarkable. Abdominal computed tomography revealed a heterogeneously enhancing right solid renal mass with a thrombus in the renal vein extending into the inferior vena cava. Magnetic resonance imaging demonstrated a renal tumor with a thrombus about 4 cm below the hepatic vein. Chest computed tomography and bone scintigraphy were negative. The patient underwent right radical nephrectomy and vena cava thrombectomy. Histophathologic evaluation of the resected tumor confirmed the diagnosis of leiomyosarcoma. She underwent no adjuvant therapy. Seven months after surgery, the patient died following a 2-month history of multiple pulmonary and hepatic metastases. CONCLUSION This report highlights the importance of considering the possibility of renal leiomyosarcoma invasion to the inferior vena cava, similar to renal cell carcinoma.
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Affiliation(s)
- Mikio Konno
- Department of UrologyHokkaido University HospitalSapporoJapan
| | - Takahiro Osawa
- Department of UrologyHokkaido University HospitalSapporoJapan
| | - Kiyohiko Hotta
- Department of UrologyHokkaido University HospitalSapporoJapan
| | - Ai Shimizu
- Department of Surgical PathologyHokkaido University HospitalSapporoJapan
| | - Takashige Abe
- Department of UrologyHokkaido University HospitalSapporoJapan
| | - Ryuji Matsumoto
- Department of UrologyHokkaido University HospitalSapporoJapan
| | - Hiroshi Kikuchi
- Department of UrologyHokkaido University HospitalSapporoJapan
| | - Nobuo Shinohara
- Department of UrologyHokkaido University HospitalSapporoJapan
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Chen C, Jiang X, Xia F, Chen X, Wang W. Clinicopathological Characteristics and Survival Outcomes of Primary Renal Leiomyosarcoma. Front Surg 2021; 8:704221. [PMID: 34746221 PMCID: PMC8566676 DOI: 10.3389/fsurg.2021.704221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Primary renal leiomyosarcoma (LMS) is an exceedingly rare entity with a poor prognosis. We summarized the clinicopathological characteristics, treatment choice, and survival outcomes of LMS from the Surveillance, Epidemiology, and End Results (SEER) database. Methods: Renal LMS and kidney renal clear cell carcinoma (KIRC) data from 1998 to 2016 were collected from the SEER database. The continuous variables were analyzed using t-tests, while the categorical variables were analyzed using Pearson's chi-squared or Fisher's exact tests. Propensity score matching (PSM) was also performed. The cancer-specific survival (CSS) and overall survival (OS) curves were estimated using Kaplan-Meier analyses and compared by log-rank tests. The risk factors for CSS and OS were estimated using univariable and multivariable Cox proportional hazard regression models. Results: A total of 140 patients with renal LMS and 75,401 patients with KIRC were enrolled. These groups differed significantly in sex, race, tumor size, grade, SEER stage, surgery, radiation, and chemotherapy. Renal LMS exhibited poorer CSS and OS compared with KIRC before and after PSM. For renal LMS, the univariate Cox proportional hazard regression model indicated that larger tumor size, higher tumor grade, higher SEER stage, and chemotherapy were risk factors for CSS and OS, while surgery appeared to be a protective factor. However, only tumor grade, SEER stage, and receiving surgery remained independent prognostic factors in the multivariable Cox proportional hazard regression model. In addition, subgroup analyses indicated that surgery remained a protective factor for advanced renal LMS. However, there was no survival benefit for patients receiving chemotherapy. Conclusions: Primary renal LMS is an exceedingly rare entity with distinct clinicopathological features and a poor prognosis. A higher tumor grade and late stage may indicate a poor prognosis. Complete tumor resection remains to be the first treatment choice, while chemotherapy may be a palliative treatment for patients with advanced disease.
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Affiliation(s)
- Cheng Chen
- Department of Urology, Xiangya Changde Hospital, Changde, China
| | - Xinjie Jiang
- Department of Urology, Xiangya Changde Hospital, Changde, China
| | - Fei Xia
- Department of Urology, Xiangya Changde Hospital, Changde, China
| | - Xudong Chen
- Department of Urology, Xiangya Changde Hospital, Changde, China
| | - Weiguo Wang
- Department of Urology, Xiangya Changde Hospital, Changde, China
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Boulma R, Ahmed YB, Oumaya M, Dhaoui A, Saidani B, Khouni H, Chouchen A. Xeroderma pigmentosum and renal leiomyosarcoma: A very rare case report association. Int J Surg Case Rep 2020; 78:310-313. [PMID: 33385877 PMCID: PMC7779535 DOI: 10.1016/j.ijscr.2020.12.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/13/2020] [Accepted: 12/15/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Xeroderma pigmentosum (XP) is a rare genetic disorder causing extreme sensitivity to ultraviolet (UV) rays. It is transmitted by an autosomal recessive mode. This disease is classically characterized by a high risk of skin cancer. The occurrence of extra-dermatological cancers in patients followed for XP has been rarely reported in the literature. We present the case of a 14-year-old adolescent with an exceptional association of XP and renal leiomyosarcoma. PRESENTATION OF CASE A 14-year-old adolescent was presented with an abdominal mass revealed by hematuria and abdominal pain. Computed tomography (CT) of the abdomen showed an enhancing, heterogeneous right renal mass, consistent with the features of renal tumor. After non conclusive biopsy, a total nephrectomy of the right kidney was performed. Based on gross specimen observation and immunochemical analysis, the patient was diagnosed with high-grade renal leiomyosarcoma. An adjuvant chemotherapy was indicated and the patient was referred to medical oncology. At 12 months follow-up, the patient is in total remission; The CT scan did not show any locoregional or distant recurrence CONCLUSION: The risk of renal tumor is increased in patients followed for XP. Attending physicians should ask for renal imaging at the slightest sign of clinical call.
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Affiliation(s)
- Rami Boulma
- Department of Surgery, FSI Hospital, La Marsa, Tunisia; University of Tunis El Manar, Tunis, Tunisia
| | - Yosra Ben Ahmed
- Department of Pediatric Surgery B, Children Hospital Bechir Hamza, 1007 Tunis, Tunisia; University of Tunis El Manar, Tunis, Tunisia
| | - Meriem Oumaya
- Department of Pediatric Surgery B, Children Hospital Bechir Hamza, 1007 Tunis, Tunisia; University of Tunis El Manar, Tunis, Tunisia.
| | - Amen Dhaoui
- Department of Pathology, FSI Hospital, La Marsa, Tunisia; University of Tunis El Manar, Tunis, Tunisia
| | - Bilel Saidani
- Department of Surgery, FSI Hospital, La Marsa, Tunisia; University of Tunis El Manar, Tunis, Tunisia
| | - Hassen Khouni
- Department of Surgery, FSI Hospital, La Marsa, Tunisia; University of Tunis El Manar, Tunis, Tunisia
| | - Adnen Chouchen
- Department of Surgery, FSI Hospital, La Marsa, Tunisia; University of Tunis El Manar, Tunis, Tunisia
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Shields LBE, Kalebasty AR. Concurrent renal cell carcinoma and hematologic malignancies: Nine case reports. World J Clin Oncol 2020; 11:644-654. [PMID: 32879850 PMCID: PMC7443826 DOI: 10.5306/wjco.v11.i8.644] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/21/2020] [Accepted: 06/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The presence of renal cell carcinoma (RCC) and hematologic malignancies (HM) in the same patient is rarely observed. Three primary findings have been described in these patients, including male gender and lymphoid malignancy predominance, and the HM are usually diagnosed before or simultaneously with the RCC. There is a lack of evidence about clinical outcomes in this setting. We report the common characteristics of 9 patients diagnosed with concurrent RCC and HM and their clinical course and response to treatment.
CASE SUMMARY Four (44%) patients were diagnosed with RCC prior to the HM, the diagnosis was simultaneous in 4 (44%) patients, and 1 (11%) patient was diagnosed with the HM prior to the RCC. No patients were treated with cytotoxic chemotherapy or radiation between the diagnosis of RCC and HM. Several unique features were seen in our case series, such as 3 simultaneous cancers in 1 (11%) patient, a splenectomy leading to remission of diffuse large B cell lymphoma without the use of chemotherapy in 1 (11%) patient, chemotherapy and rituximab for lymphoma resulting in a complete response in primary RCC in 1 (11%) patient, and immunotherapy providing an excellent response for primary renal leiomyosarcoma in 1 (11%) patient.
CONCLUSION These findings highlight the potential role of immune system dysregulation in patients with the diagnosis of RCC and HM whereby the first malignancy predisposes to the second through an immunomodulatory effect. HM have the potential of being confused with lymph node metastasis from kidney cancer. Lymph node biopsy may be necessary at the time of initial diagnosis or in cases of mixed response to therapy. Long-term medical surveillance is warranted when a patient is diagnosed with RCC or HM. Clinicians should be aware of the higher prevalence of male gender and lymphoid malignancy with concurrent RCC and HM and that either of these conditions may be diagnosed first or they may be diagnosed simultaneously.
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Affiliation(s)
- Lisa BE Shields
- Norton Neuroscience Institute, Norton Healthcare, Louisville, KY 40202, United States
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Matoso A, Yakirevich E, Mangray S. Mesenchymal Kidney Tumors. KIDNEY CANCER 2020. [DOI: 10.1007/978-3-030-28333-9_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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10
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Kundu R, Chandra M, Punia RS, Aggarwal P. Primary Renal Leiomyosarcoma Arising from Renal Vein: A Case Report of Rare Entity with Review of Literature. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_232_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractPrimary renal sarcomas are extremely rare neoplasms accounting for about 1% of all malignant renal neoplasms. Among all the sarcomas of kidney, leiomyosarcoma is the most common histotype. The histogenesis of these tumors is unclear, and presumably, they arise either from renal capsule or smooth muscle of renal vessels or renal pelvis. We report a case of a 65-year-old woman, who presented with intermittent abdominal pain for 1 year. The correct diagnosis was established only after the histopathological analysis of the resected specimen. The poor prognosis borne by these tumors mandates a thorough evaluation of all renal masses with unusual gross and histomorphology.
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Affiliation(s)
- Reetu Kundu
- Departments of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Mahesh Chandra
- Departments of Urology, Government Medical College and Hospital, Chandigarh, India
| | - Rajpal Singh Punia
- Departments of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Purnima Aggarwal
- Departments of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
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Vasquez Ciriaco S, García Espinoza JA, Garcia Pedro EE. Primary leiomyosarcoma of kidney with metastasis to contralateral kidney. Case report. Interv Med Appl Sci 2018; 10:98-101. [PMID: 30363298 PMCID: PMC6167618 DOI: 10.1556/1646.10.2018.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 02/08/2018] [Accepted: 02/18/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Renal leiomyosarcoma is a rare entity in the world and its understanding is based on reports and various cases; however, the prognosis is bleak for its malignant potential and an average survival of 18 months. CLINICAL CASE A 54-year-old woman with a clinical picture of 6 months of pain in the right flank and a tomographic image of a bilateral renal lesion underwent right radical nephrectomy and left conservative surgery. The definitive histopathological study reported right primary renal leiomyosarcoma with left metastasis. CONCLUSION Renal leiomyosarcoma is an entity of low incidence and high mortality; however, our case represents the minority of patients with contralateral kidney metastasis reported in the literature.
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Affiliation(s)
- Sergio Vasquez Ciriaco
- Department of Oncological Surgery, Regional Hospital of High Specialty of Oaxaca, Oaxaca, Mexico
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Makis W, Brimo F, Probst S. Primary Renal Leiomyosarcoma Presenting with Subcutaneous and Osseous Metastases: Staging and Follow-Up with 18F-FDG PET/CT. Nucl Med Mol Imaging 2018; 52:69-73. [PMID: 29391915 PMCID: PMC5777953 DOI: 10.1007/s13139-016-0467-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 12/02/2016] [Accepted: 12/20/2016] [Indexed: 11/29/2022] Open
Abstract
A 60 year old woman who presented with multiple small subcutaneous nodules in the upper back and arms, was referred for an [18F] fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) after histological evaluation revealed metastatic leiomyosarcoma of unknown origin. The PET/CT showed multiple 18F-FDG-avid subcutaneous nodules, bone lesions, as well as a large left renal mass, which was biopsied to confirm a primary renal leiomyosarcoma arising from the renal parenchyma. A post therapy PET/CT showed overall progression of disease. The use of 18F-FDG PET/CT in the staging and evaluation of response to therapy of a renal leiomyosarcoma has not been previously described in the literature.
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Affiliation(s)
- William Makis
- Diagnostic Imaging, Cross Cancer Institute, 11560 University Ave NW, Edmonton, Alberta T6G 1Z2 Canada
| | - Fadi Brimo
- MUHC Glen Site, Pathology, 1001 Decarie Blvd, Montreal, Quebec H4A 3J1 Canada
| | - Stephan Probst
- Jewish General Hospital, Nuclear Medicine, 3755 Chemin de la Cote-Sainte-Catherine, Montreal, Quebec H3T 1E2 Canada
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Abstract
Primary renal leiomyomas and leiomyosarcomas are rare, and there is a paucity of data regarding the pathologic features and outcomes of patients with these tumors. The objective of this study was to review a large series of renal smooth muscle tumors, in order to more fully elucidate their natural histories. Fifty-seven renal smooth muscle tumors were reviewed for various histopathologic features, and leiomyosarcomas were graded using the French Federation of Cancer Centers (FNCLCC) system. Tumor cores in tissue microarrays were evaluated for smooth muscle actin, desmin, h-caldesmon, calponin, myogenin, cytokeratin (OSCAR), CD117, Ki67, estrogen receptor (ER), progesterone receptor (PR), and Wilms tumor 1 (WT1). Leiomyomas were selected on the basis of preexisting diagnostic criteria, which included a lack of cytologic atypia, necrosis, and mitotic activity (0 to 1 mitoses/10 hpf). These were found to have a strong predilection for women, tended to arise from the renal capsule, were small (mean size, 4.2 cm), and had a low Ki67 proliferative rate (mean 1.4%). In addition, they uniformly expressed all smooth muscle markers and were ER/PR/WT1 positive in nearly all cases. In 10 patients with clinical follow-up, none had a tumor recurrence. In contrast, leiomyosarcomas had an equal sex distribution, were larger (mean size, 9.8 cm), had significantly higher mitotic activity (mean 8.6 mitoses/10 hpf), with most being FNCLCC grade 2. Leiomyosarcomas expressed at least 1 muscle marker, higher Ki67 proliferative activity (mean 20.4%) than leiomyomas, and most were ER/PR/WT1 negative. Tumor recurrence occurred in 65% of patients, and 35% of patients died of disease. This study therefore validates existing criteria to distinguish between leiomyomas and leiomyosarcomas.
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Öziş SE, Gülpınar K, Şahlı Z, Konak BB, Keskin M, Özdemir S, Ataoğlu Ö. Recurrent renal giant leiomyosarcoma. ULUSAL CERRAHI DERGISI 2016; 32:145-8. [PMID: 27436926 DOI: 10.5152/ucd.2014.2153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 04/06/2014] [Indexed: 11/22/2022]
Abstract
Primary renal leiomyosarcomas are rare, aggressive tumors. They constitute 1-2% of adult malignant renal tumors. Although leiomyosarcomas are the most common histological type (50-60%) of renal sarcomas, information on renal leiomyosarcoma is limited. Local or systemic recurrences are common. The radiological appearance of renal leiomyosarcomas is not specific, therefore renal leiomyosarcoma cannot be distinguished from renal cell carcinoma by imaging methods in all patients. A 74-year-old female patient presented to our clinic complaining of a palpable mass on the right side of her abdomen in November 2012. The abdominal magnetic resonance imaging revealed a mass, 25 × 24 × 23 cm in size. Her past medical history revealed that she has undergone right radical nephrectomy in 2007, due to a 11 × 12 × 13 cm renal mass that was then reported as renal cell carcinoma on abdominal magnetic resonance imaging, but the pathological diagnosis was low-grade renal leiomyosarcoma. The most recent follow-up of the patient was in 2011, with no signs of local recurrence or distant metastases within this four-year period. The patient underwent laparotomy on November 2012, and a 35 cm retroperitoneal mass was excised. The pathological examination of the mass was reported as high-grade leiomyosarcoma. The formation of this giant retroperitoneal mass in 1 year can be explained by the transformation of the lesion's pathology from low-grade to a high-grade tumor.
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Affiliation(s)
- Salih Erpulat Öziş
- Department of General Surgery, Ufuk University School of Medicine, Ankara, Turkey
| | - Kamil Gülpınar
- Department of General Surgery, Ufuk University School of Medicine, Ankara, Turkey
| | - Zafer Şahlı
- Department of General Surgery, Ufuk University School of Medicine, Ankara, Turkey
| | - Baha Burak Konak
- Department of General Surgery, Ufuk University School of Medicine, Ankara, Turkey
| | - Mete Keskin
- Department of General Surgery, Ufuk University School of Medicine, Ankara, Turkey
| | - Süleyman Özdemir
- Department of General Surgery, Ufuk University School of Medicine, Ankara, Turkey
| | - Ömür Ataoğlu
- Department of Pathology, Private Mikro-Pat Laboratory, Ankara, Turkey
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Glockner JF, Lee CU. Magnetic Resonance Imaging of Perirenal Pathology. Can Assoc Radiol J 2016; 67:149-57. [PMID: 26831730 DOI: 10.1016/j.carj.2015.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 07/31/2015] [Accepted: 08/01/2015] [Indexed: 01/08/2023] Open
Abstract
The perirenal space can be involved by a variety of neoplastic, inflammatory, infectious, and proliferative disorders. Magnetic resonance imaging is often an ideal technique for identification and staging of lesions arising within the perirenal space, with its superior soft tissue characterization as well as its ability to visualize extension into blood vessels and adjacent organs. This pictorial essay describes the magnetic resonance imaging appearance of a variety of pathologies which can arise from or involve the perirenal space, and provides a framework for categorization and differential diagnosis of these lesions.
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Affiliation(s)
- James F Glockner
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
| | - Christine U Lee
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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16
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Van Lierop D, Raheem OA, Siegel J, Lee HJ. A rare case of Epstein-Barr virus-associated leiomyosarcoma of the kidney in a patient with HIV. Actas Urol Esp 2015. [PMID: 26211573 DOI: 10.1016/j.acuro.2015.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- D Van Lierop
- Department of Urology, University of California, Irvine, Orange, CA, EE.UU
| | - O A Raheem
- Department of Urology, University of California, San Diego, La Jolla, CA, EE.UU
| | - J Siegel
- Department of Urology, University of California, Irvine, Orange, CA, EE.UU
| | - H J Lee
- Department of Urology, University of California, San Diego, La Jolla, CA, EE.UU..
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17
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Moreira DM, Gershman B, Thompson RH, Okuno SH, Robinson SI, Leibovich BC, Boorjian SA. Clinicopathologic characteristics and survival for adult renal sarcoma: A population-based study. Urol Oncol 2015; 33:505.e15-20. [PMID: 26321056 DOI: 10.1016/j.urolonc.2015.07.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/27/2015] [Accepted: 07/29/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION To analyze the association of clinicopathologic characteristics and treatment modality with survival among adult patients with renal sarcoma. METHODS We identified 489 adults diagnosed with renal sarcoma from the Surveillance, Epidemiology and End Results registry between 1973 and 2011. Cancer-specific survival was estimated using the Kaplan-Meier method and was compared between groups with log rank and Cox models. RESULTS Median age at diagnosis was 61 years, while median tumor size was 11 cm. Tumor histology was leiomyosarcoma in 175, liposarcoma in 100, other subtypes in 129, and unknown in 85 cases. Tumor stage at diagnosis was nonmetastatic in 322 (67%) and metastatic in 167 (33%) cases. Treatment of nonmetastatic disease was surgical resection in 171 patients, radiation in 24, both in 35, neither in 18, and unknown in 74 cases. Treatment of metastatic disease was surgery in 39 patients, radiation in 27, both in 11, neither in 42, and unknown in 48. For nonmetastatic and metastatic disease, 5-year cancer-specific survival rates were 58% and 16%, respectively. On multivariable analysis, surgery was associated with decreased cancer-specific mortality among both patients with nonmetastatic disease (hazard ratio = 0.34; 95% CI: 0.14-0.85) and those with metastatic disease (hazard ratio = 0.38; 95% CI: 0.18-0.77). Age, race, tumor size, and tumor grade were independently associated with cancer death in nonmetastatic disease, whereas race and tumor histology remained associated with mortality in metastatic disease (all P < 0.05). CONCLUSION Although metastatic renal sarcoma has an ominous prognosis, durable survival may be achieved for localized tumors. Although we recognize the potential for selection bias, our results suggest an association between surgical resection and decreased mortality for both nonmetastatic and metastatic renal sarcoma.
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Tajima S, Waki M, Fukuyama M. Pleomorphic leiomyosarcoma with a dedifferentiation-like appearance in the kidney: case report and literature review. Med Mol Morphol 2015; 49:238-242. [PMID: 25910609 DOI: 10.1007/s00795-015-0103-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
Abstract
Although primary leiomyosarcoma of the kidney is extremely rare, it is the most common sarcoma of the kidney. Leiomyosarcoma with a large pleomorphic component is designated as pleomorphic leiomyosarcoma. The pleomorphic component is usually similar to undifferentiated high-grade pleomorphic sarcoma, although it variably expresses smooth muscle markers on immunohistochemistry. In the few reported cases of pleomorphic leiomyosarcoma of the kidney, cases with the pleomorphic component showing distinct nodularity similar to dedifferentiated leiomyosarcoma have not been described, to the best of our knowledge. Herein, we present a case of a 49-year-old woman with pleomorphic leiomyosarcoma in the kidney showing distinct nodularity of smooth muscle marker-expressing pleomorphic cells within a background of classic leiomyosarcoma. Along with the classification as a pleomorphic leiomyosarcoma, suggesting aggressive clinical behavior, the renal origin itself might also be a predictor of poor prognosis, as shown in a previous study. This case also involved concomitant distant metastases, already present during the initial detection of the renal tumor.
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Affiliation(s)
- Shogo Tajima
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
| | - Michihiko Waki
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Masashi Fukuyama
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
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Renal leiomyoma: a contemporary multi-institution study of an infrequent and frequently misclassified neoplasm. Am J Surg Pathol 2015; 39:349-56. [PMID: 25517956 DOI: 10.1097/pas.0000000000000354] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Renal leiomyoma is an exceptionally rare benign mesenchymal tumor of the kidney predominantly arising in proximity of the renal capsule or pelvis. Its rarity and nonspecific clinical and imaging features may lead to radical or partial nephrectomy on the basis of preoperative suspicion of renal cell carcinoma. The diagnosis of renal leiomyoma is challenging because of the histologic overlap with lipid-poor angiomyolipoma (AML). We conducted a multi-institution study to characterize renal leiomyoma in greater detail. We collected and reviewed 24 cases diagnosed initially as renal leiomyoma in 10 institutions from North America, Canada, and Europe. Immunohistochemical expression of desmin, HMB-45, estrogen receptor (ER), progesterone receptor (PR), and cathepsin K was evaluated. Upon central review, 9 tumors were classified as renal leiomyoma, whereas the remaining were reclassified as AML (n=13), myolipoma (n=1), and medullary fibroma (n=1). All renal leiomyomas were solitary and occurred in female patients (mean age 63 y; range, 44 to 74 y). Tumor size ranged from 0.6 to 7.0 cm (mean 2.9 cm); 7 originated from the renal capsule or the subcapsular area and 1 from a large vessel in the renal sinus. All leiomyomas were diffusely positive for desmin and negative for HMB-45 and cathepsin K; 6/9 (67%) showed diffuse ER and PR expression, and 1 case showed focal ER positivity only. Renal leiomyoma should be included in the histologic differential diagnosis of solid renal masses, particularly in perimenopausal women. The main differential diagnosis is with lipid-poor AML, and cathepsin K plays a key role in distinguishing these 2 lesions.
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20
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Narula V, Siraj F, Bansal A. Renal leiomyosarcoma with soft tissue metastasis: An unusual presentation. Can Urol Assoc J 2015; 9:E139-41. [PMID: 25844101 DOI: 10.5489/cuaj.2396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Primary renal sarcomas are exceptionally rare, constituting 1% of all malignant renal tumours. Since the prognosis for a renal sarcoma is particularly poor, differentiation from sarcomatoid renal cell carcinoma (RCC) is necessary. Histopathology and immunohistochemistry are the only modes of diagnosing these sarcomas as they have no specific features clinically and radiologically. We report a case of renal leiomyosarcoma which was clinically diagnosed as RCC. Histopathology revealed a spindle cell sarcoma and immunohistochemistry (IHC) confirmed a renal leiomyosarcoma. She also had a liver nodule and mass in the right side of neck and left arm. Biopsy from these sites revealed a similar morphology and IHC confirmed leiomyosarcoma. We report a case illustrating the rarity of this disease and its aggressive nature owing to fatal metastatic potential.
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Affiliation(s)
- Varsha Narula
- National Institute of Pathology, Indian Council of Medical Research, Delhi, India
| | - Fouzia Siraj
- National Institute of Pathology, Indian Council of Medical Research, Delhi, India
| | - Anju Bansal
- National Institute of Pathology, Indian Council of Medical Research, Delhi, India
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22
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Kwon YS, Salmasi A, Han CS, Hon JDC, Singer EA. Renal Leiomyosarcoma: Case Report and Review of the Literature. ACTA ACUST UNITED AC 2015; 4:213-217. [PMID: 27087881 DOI: 10.14740/wjnu214w] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Leiomyosarcoma of the kidney is a rare entity, and our understanding of this type of renal sarcomas is limited. A 46-year-old Caucasian male presented with a chief complaint of right flank pain for one month. He came to our facility for an additional opinion regarding the management of his renal mass. Computed tomography (CT) of the abdomen showed an enhancing, heterogeneous right renal mass, consistent with the features of renal cell carcinoma (RCC). Robotic-assisted total nephrectomy of the right kidney revealed a tan mass with central necrosis that involved the upper pole of the kidney. Based on gross specimen observation and immunochemical analysis, the patient was diagnosed with high-grade leiomyosarcoma. While the prognosis is poor, radical nephrectomy remains the treatment of choice. The potential benefits of adjuvant therapy should be discussed with selected patients.
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Affiliation(s)
- Young Suk Kwon
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Amirali Salmasi
- Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | | | - Jane Date C Hon
- Department of Pathology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Eric A Singer
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
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23
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Renal leiomyosarcoma: a diagnostic challenge. Case Rep Oncol Med 2013; 2013:459282. [PMID: 24288636 PMCID: PMC3830810 DOI: 10.1155/2013/459282] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 07/07/2013] [Indexed: 12/19/2022] Open
Abstract
Renal leiomyosarcoma is a very rare tumor that clinically and radiographically mimics more common renal malignancies. The infrequency of the condition makes it very difficult to diagnose. A 70-year-old male smoker presented with months of hematuria, right-sided flank pain, and weight loss. Imaging revealed a 3.8-centimeter renal mass that had characteristics similar to renal cell carcinoma. Initial biopsy of the mass was negative for malignancy. Two months later, subsequent imaging revealed what appeared to be metastatic bone lesions. Again, a biopsy of one of the lesions was negative for malignancy. Subsequent ureteral pyeloscopy, ureteroscopic renal pelvis biopsy, and brush cytology were negative for malignancy as well. The decision was made to perform nephrectomy for the removal of the mass. Pathologic analysis revealed renal leiomyosarcoma. This case illustrates the difficulty in diagnosing renal leiomyosarcoma. Repeated pathologic sampling was negative because of the tumor heterogeneity. Prompt diagnosis and treatment are very significant as surgical resection at an early stage offers the best prognosis.
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24
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Dhawan S, Chopra P, Dhawan S. Primary renal leiomyosarcoma: A diagnostic challenge. Urol Ann 2012; 4:48-50. [PMID: 22346103 PMCID: PMC3271452 DOI: 10.4103/0974-7796.91623] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 01/01/2011] [Indexed: 01/10/2023] Open
Abstract
Primary leiomyosarcoma is an extremely rare entity constituting only 0.5-1% of all invasive renal tumors. It is frequently diagnosed on histological examination because it does not have any specific diagnostic features clinically and radiologically. At times, it is difficult to differentiate leiomyosarcoma from the sarcomatoid renal cell carcinoma even in histopathology as both the tumors have spindle-shaped atypical cells. Moreover, some epithelial markers can be present in pure smooth muscle sarcomas, while some smooth muscle markers are positive in carcinomas. Hence, a diagnosis of primary renal leiomyosarcoma should be made with caution. Since the prognosis for a renal sarcoma is particularly poor, differentiation from sarcomatoid renal cell carcinoma is necessary. The diagnostic challenge of one such tumor is discussed.
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Affiliation(s)
- Shashi Dhawan
- Department of Pathology, Sir Ganga Ram Hospital, New Delhi, India
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25
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Abstract
The vast majority of primary renal masses represent clear cell or papillary renal cell carcinomas, angiomyolipomas, or transitional cell carcinomas. However, a number of more rare masses can also be encountered, many of which can be very difficult to differentiate from these more common entities based on their imaging features. These uncommon entities include metanephric adenoma, epithelioid angiomyolipoma, medullary renal cell carcinomas, multilocular cystic nephroma, hemangiopericytoma, hemangioma, leiomyoma, leiomyosarcoma, solitary fibrous tumor, renal plasmacytomas, and mixed epithelial and stromal tumors. In some cases, certain clinical and imaging features can allow one of these unusual entities to be placed in the differential diagnosis, including patient age, degree of tumor enhancement, presence of underlying sickle cell trait or sickle cell disease, the presence of a cystic component to the tumor, and tumor morphology. Even if a radiologist is unable to make a specific diagnosis, knowledge of these entities is important, as it allows radiologists to guide post-surgical follow-up, as well to understand the most common sites of metastatic disease.
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Affiliation(s)
- Siva P Raman
- Department of Radiology, Johns Hopkins University, JHOC 3251, 601 N. Caroline Street, Baltimore, MD 21287, USA.
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27
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Huang ZM, Li HZ, Ji ZG, Shi BB. Diagnosis and treatment of primary adult renal sarcoma. ACTA ACUST UNITED AC 2012; 26:172-4. [PMID: 22207927 DOI: 10.1016/s1001-9294(11)60044-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE To investigate the clinical characteristics of primary adult renal sarcoma. METHODS A total of 1654 cases with adult renal tumors were treated during 1985 to 2009 in Peking Union Medical College Hospital. Of all, 17 cases were diagnosed as primary renal sarcoma and underwent radical nephrectomy. The clinical features of 17 such patients were retrospectively analyzed. RESULTS The first symptom of 10 (59%) cases in all renal sarcomas was abdominal mass. The pathological diagnosis was leiomyosarcoma (7 cases), rhabdomyosarcoma (2 cases), malignant fibrous histiocytoma (2 cases), low-differentiated sarcoma (2 cases), chromophobe renal cell carcinoma coexisting with liposarcoma (1 case), fibrosarcoma (1 case), embryonic sarcoma (1 case) and leiomyosarcoma (1 case). One patient died of tumor thrombus of the inferior vena cava during surgery. Finally, 15 cases were regularly followed up for 4 to 60 months. Till now, 1 had tumor-free survival for 9 months, and the other 14 cases died 2-38 months after the operation with a median survival time of 18 (range, 5-60) months. The median survival time of leiomyosarcoma group was 28 (range, 11-60) months, and 2 cases of malignant fibrous histiocytoma died 4 and 8 months after the operation respectively. CONCLUSIONS The primary renal sarcoma has the clinical symptom similar with advanced renal cell carcinoma and has poor prognosis. Leiomyosarcoma might have relative good prognosis.
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Affiliation(s)
- Zhong-ming Huang
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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28
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Kim YJ, Moon HS, Lee ES, Sung JK, Jeong HY, Kim JY, Kang DY. Recurrent renal leiomyosarcoma mimicking a colonic submucosal tumor: a case report. JOURNAL OF THE KOREAN SOCIETY OF COLOPROCTOLOGY 2011; 27:270-4. [PMID: 22102979 PMCID: PMC3218133 DOI: 10.3393/jksc.2011.27.5.270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 09/06/2011] [Indexed: 01/15/2023]
Abstract
A primary leiomyosarcoma of the kidney is a rare, but highly aggressive, neoplasm, accounting for only 0.1% of all invasive renal tumors. Local or systemic recurrence is common, but a leiomyosarcoma is difficult to diagnose preoperatively. We recently encountered an interesting case of an unusual recurrence of a renal leiomyosarcoma. A 57-year-old woman visited our hospital complaining of lower abdominal pain. Four years previously, she had undergone a left nephrectomy. She had a primary leiomyosarcoma of the kidney that had been misdiagnosed as a renal cell carcinoma. Colonoscopy revealed the presence of a lesion similar to a submucosal tumor in the descending colon. Postoperative pathologic examination confirmed that the mass was a recurrent leiomyosarcoma. We report this unusual case and present a review of the literature.
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Affiliation(s)
- Yun Jeung Kim
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
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29
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Ellouze S, Abid N, Kossentini M, Gouiaa N, Charfi S, Mhiri N, Boudawara T. Leiomyosarcoma of the kidney. Clin Genitourin Cancer 2011; 9:68-9. [PMID: 21764393 DOI: 10.1016/j.clgc.2011.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 05/02/2011] [Accepted: 05/13/2011] [Indexed: 10/17/2022]
Affiliation(s)
- Sameh Ellouze
- Department of Pathology, Habib Bourguiba Hospital, Sfax, Tunisia.
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30
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Wang X, Xu R, Yan L, Zhuang J, Wei B, Kang D, Wu K, Xie L, Xie Z, Wei Q, Li X, Zeng H, Lu Y. Adult Renal Sarcoma: Clinical Features and Survival in a Series of Patients Treated at a High-volume Institution. Urology 2011; 77:836-41. [DOI: 10.1016/j.urology.2010.09.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 09/16/2010] [Accepted: 09/16/2010] [Indexed: 10/18/2022]
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31
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Bhat GS, Nelivigi GG, Shivalingaiah M, Ratkal CS. Primary renal leiomyosarcoma: Case report and literature review. AFRICAN JOURNAL OF UROLOGY 2011. [DOI: 10.1007/s12301-011-0004-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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