Epithelioid hemangioendothelioma arising from the kidney- a
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Epithelioid hemangioendothelioma (EH) is a rare angiocentric vascular tumor of intermediate biologic behavior with metastatic potential. It was initially grouped along with other hemangioendotheliomas, however due to the aggressive biological behavior, it is now grouped in angiosarcomas according to the current World Health Organization (WHO) classification. Hemangioendotheliomas have been reported in various sites, which are most commonly in soft tissues followed by liver, lung, bone, peritoneum, stomach, thyroid, and central nervous system. Kidney is an extremely rare site, especially for the epithelioid variant.

A 30-year- old woman without family history of malignant tumor was admitted to our hospital with 3-months history of gross hematuria without obvious cause and aggravated for half a month. And this patient had no fever, vomiting, or urinary syndromes. The symptoms were slightly better after being treated with anti-infection treatment. The occasional feeling of discomfort at the waist was unpleasant, so the patient came to our hospital for further treatment. A mass measuring 1.1 cm was noted in the mid pole of the left kidney on computed tomography (CT) images (Fig. 1). Otherwise, she had a history of appendicectomy, and she denied recent weight loss. All other blood analysis including tumor markers and the chest CT completed before surgery showed no abnormalities.

The patient subsequently underwent ureteroscopy and partial left nephrectomy. During operation, a small, soft, and cystic mass measuring about 0.5 cm was identified at the upper pole of the left kidney. The intraoperative frozen pathology revealed a renal vascular tumor like lesion in the left renal pelvis with vascular network distribution, and we observed lining cell dysplasia and inflammation, infarction and ulcer.

Source: Medicine: August 2019 - Volume 98 - Issue 34

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