ABSTRACT
Objective Explore the diagnosis experience of sarcomatoid renal cell carcinoma (SRCC).Method There were 5 cases of SRCC from April 2011 to June 2013,3 of them were females and 2 were males,with a mean age of 49 (27-71).All the patients were presented with pain accompanied with other symptoms such as hematuria,fever and polyuria.CT urography suggested renal occupied lesions,withuneven density and enhancement,and malignancy was highly suspected.The mean diameter of tumors was 9.2 cm(4-18 cm).Radical nephrectomy was performed on all patients,tumors were located in renal parenchymal,and with adherence to other tissues.One patient with lung metastasis was found before surgery.Result Pathologic findings of the resected tissues after operation noted SRCC.Under the microscope,a large number of spindle shaped cells were seen,and Vimentin and PCK were all positive in immunohistochemical.Three patients with metastases were found after surgery (adrenal gland,liver,pancreas).Postoperative pathological stages were one T2N0M1,three T4N0M1 and one T3N0M0.One patient received IL-2 immunotherapy.All patients died within 9 months after surgery with a median survival of 3.8 months.Immunohistochemistry in the postoperative,there were four patients with the level of Ki-67 LI ＞ 50％,with distant metastasis and survival time was 1-4 moths.Conclusion The disease develops rapidly,and the prognosis of the patients is very poor.The Ki-67 LI may be considered as a prognosis marker and the patients with sarcomatoid differentiation can benefit little from surgery alone.
ABSTRACT
Sarcomatoid renal cell carcinoma is an uncommon tumor that has to be distinguished from renal carcinosarcoma. We have described three cases of sarcomatoid renal cell carcinoma showing different clinical and light microscopic features. An ultrastructural study of the tumor cells from the sarcomatoid area revealed frequent desmosomal junction, confirming the epithelial nature of the neoplasm. All three cases showed an aggressive clinical course and tended to invade adjacent organs or tissues. We believe that an histological and immunohistochemical examination in conjunction with an electron microscopic examination are necessary to diagnose sarcomatoid renal cell carcinoma.
Subject(s)
Carcinoma, Renal Cell , Carcinosarcoma , Desmosomes , Microscopy, ElectronABSTRACT
Sarcomatoid renal cell carcinoma is uncommon and constitutes approximately 1.0% to 1.5% of all renal parenchymal tumors. Renal tumors that consist of epithelial and sarcomatoid components were called Sarcomatoid renal cell carcinomas. Its distinction from other morphological variants of renal cell carcinoma is significant, because it has been shown to have a much poorer prognosis than the purely epithelial tumors. The diagnosis of sarcomatoid renal cell carcinoma is usually made when epithelial and sarcomatoid components are mixed in nephrectomy specimen. A case of sarcomatoid renal cell carcinoma is herein presented in a 77 year-old women. she complained right flank pain and high fever for 3 days, radical nephrectomy was performed and diagnosis was made by H-E stains and immunohistochemical stains of nephrectomy specimen. A brief review about sarcomatoid renal cell carcinoma is made.