Adult renal sarcoma: A rare case of recurrence 13 years afte
Published in the Clinical Case Reports, the authors present a novel case of a locally advanced renal sarcoma that recurred 13 years after its initial resection.

A 55‐year‐old patient initially presented with gross hematuria and left flank pain. His physical exam revealed a palpable left abdominal mass. Past medical history was consistent with hypertension and dyslipidemia. Computed tomography (CT) showed a large mass occupying most of the left kidney, consistent with renal malignancy.

A left radical nephrectomy with ipsilateral lymph node dissection was performed through left subcostal approach and mobilization of spleen and pancreas. The patient normally recovered after the operation and was discharged four days later.

The pathology indicated malignant sarcoma involving the left kidney and peri‐renal adipose tissue. The mass measured 13.0 × 9.5 × 6.5 cm. There was no involvement of the renal vein or adrenal gland, and the two lymph nodes examined had no evidence of malignancy. Most of the tumor showed hypercellular fascicles of spindle cells with elongated, hyperchromatic nuclei, and eosinophilic cytoplasm.

Thin, pink, wavy fibers between the tumor cells were characteristic of collagen and were indicative of a sarcoma with fibroblastic differentiation. Tissue taken adjacent to the main tumor mass showed lobules of mature adipose tissue separated by thick fibrous septa containing scattered atypical cells with enlarged, hyperchromatic nuclei; these latter features are seen in well‐differentiated liposarcoma. Also, the tumor cells were negative for keratin, S‐100, H‐Caldesmon, desmin, CD34, and CD99 by immunohistochemistry.

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