Knowledge of cytogenetic analysis for synovial sarcoma in sarcomatoid variant renal cell carcinoma.

Sarcomatoid change in a renal tumor should undergo cytogenetic analysis of t(x;18) to prevent a missed diagnosis of synovial sarcoma. Surgeons should be vigilant regarding pathological correlation.

Case report of an unexpected inflammatory myofibroblastic tumor.

INTRODUCTION: Inflammatory myofibroblastic tumor is a benign entity that may present as a locally aggressive malignancy, predominantly in the lung. 500 cases have been reported in the literature, and an estimated prevalence ranges from 0.04% to 0.7%. CASE PRESENTATION: An eighteen-year old male presented to the surgical clinic with abdominal pain. The pain was recurring despite trials of analgesics and remained undiagnosed. Radiological imaging demonstrated a lesion in the spleen. An infectious cause was presumed due to their endemicity in South Asia, however pathology showed an inflammatory myofibroblastic tumor. DISCUSSION: Pre-operative imaging is yet to develop a set criterion that may identify this lesion, though clinicians may be clued in by the benign appearance despite the large size. Usual diagnosis is on pathology after complete surgical excision, which is the mainstay treatment advocated. CONCLUSION: Reporting of the tumor in unusual sites such as the spleen is scarce, increase of which may help establish guidelines, understand tumor behavior and guide clinicians that may encounter it in surgical practice.