Sarcomatoid Renal Cell Carcinoma: Report of a Large Malignant Tumor with a Review of the Literature

Abstract

Introduction: Sarcomatoid renal cell carcinoma is a rare and aggressive kidney tumor with poor prognosis and distinct microscopic features. Traditional modalities versus new targeted therapy are used in different patients with controversial but some promising results.

Method: A 73-year-old man was referred with right flank pain and hematuria. Computed tomography (CT) scan reported a solid mass measuring 62x100 mm in the posterior right kidney with perinephric infiltration. Multiple tumor nodules were present in perinephric fat. A metastatic mass measuring 21x33 mm in the right adrenal gland with a few metastatic lymph nodes measuring 18 mm in the paraaortic, renal hilum, and right retro crural space were also present.

Result: Radical nephrectomy was done. The cut section of the kidney revealed firm, homogeneous gray- yellowish huge mass measured 13.5 cm. The pathologist reported:" Renal cell carcinoma, Sarcomatoid type, High grade (4/4) invading perirenal fat with a greatest diameter of 13.5 cm and free surgical and vascular margin. IHC was done with CK, Vimentin, and CD10 positive and EMA, CK7, Desmin, Myogenin, and E-Cadherin negative". Unfortunately the patient passed away 25 days later in the background of lung and cardiac failure.

Conclusion: Pathologists and clinicians should be familiar by this rare, but aggressive, entity for sooner diagnosis and treatment. Different treatments should be assessed for better service to the patient.