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Primary leiomyosarcoma of the kidney
Kusuma Venkatesh1, Monika Lamba Saini, S R Niveditha
1Department of Pathology, Kempegowda Institute of Medical Sciences, Bangalore 560004, India.
Pathology Research International
|December 15, 2010
Summary
Primary renal leiomyosarcoma, a rare and aggressive kidney tumor, was diagnosed in a 55-year-old woman. Thorough investigation is crucial for spindle cell tumors in the kidney.
Area of Science:
- Oncology
- Pathology
Background:
- Primary leiomyosarcoma of the kidney is an exceptionally rare malignancy.
- It is characterized by aggressive clinical behavior.
Observation:
- A 55-year-old female presented with a left-sided abdominal mass. Radiologic imaging indicated a renal origin with colonic adhesions.
- Surgical intervention involved radical nephrectomy and hemicolectomy. The tumor extensively replaced the left kidney, exhibiting a focal whorled appearance on cut section.
Findings:
- Microscopic examination revealed malignant spindle cells with cigar-shaped nuclei.
- Immunohistochemical staining confirmed smooth muscle origin (positive for smooth muscle actin).
- The tumor was negative for cytokeratin, ruling out sarcomatoid variant of renal cell carcinoma.
Implications:
- Spindle cell morphology in renal tumors necessitates comprehensive differential diagnosis.
- Misdiagnosis as sarcomatoid renal cell carcinoma can be avoided with thorough pathological investigation.
- This case highlights the importance of immunohistochemistry in diagnosing rare renal neoplasms.
