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Sarcomatoid renal cell carcinoma mimicking a non-functioning kidney with stone: A rare case report

  • Faridz Albam Wiseso ,
  • Raden Danarto ,
  • Hanggoro Tri Rinonce ,
  • Nita Sahara ,
  • Dewa Nyoman Murti Adyaksa ,
  • Yana Supriatna ,

Abstract

Background: Sarcomatoid differentiation is a rare variant of renal cell carcinoma (RCC) and is associated with a worse prognosis. To date, there is still no reliable method to diagnose sarcomatoid renal cell carcinoma (sRCC) preoperatively. This malignancy is sometimes hidden in the minority cases of the non-neoplastic disease, making it difficult to diagnose and leading to diagnostic pitfalls particularly in limited diagnostic tool settings.

Case presentation: A 72-year-old male presented with mild, dull pain in the left flank for one year. The initial assessment revealed a non-functioning left kidney with severe hydronephrosis and a stone. However, after a simple nephrectomy was done, the pathological examination showed a sarcomatoid variant of RCC. In the following weeks, a recurrent inhomogeneous tumor aggressively raised in the left kidney bed infiltrating the adjacent structures to the abdominal wall. An embolization procedure of the tumor feeding artery was carried out followed by administration of tyrosine kinase inhibitor. However, the patient’s condition quickly deteriorated and survived for about one month.

Conclusion: In the non-functional kidney associated with stone, a consideration of potentially malignant lesions as a differential diagnosis is suggested. A rare sRCC with the worst prognosis may also exist in this condition. A thorough preoperative examination must be done carefully to avoid a diagnostic pitfall.

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How to Cite

Wiseso, F. A., Danarto, R., Rinonce, H. T., Sahara, N., Adyaksa, D. N. M., & Supriatna, Y. (2021). Sarcomatoid renal cell carcinoma mimicking a non-functioning kidney with stone: A rare case report. Indonesia Journal of Biomedical Science, 15(2), 126–130. https://doi.org/10.15562/ijbs.v15i2.350

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