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

doi:10.15562/ijbs.v15i2.350

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 ,

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DOI: https://doi.org/10.15562/ijbs.v15i2.350 |
Published: 2021-10-27

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.

References

Shuch B, Bratslavsky G, Linehan WM, Srinivasan R. Sarcomatoid renal cell carcinoma: A comprehensive review of the biology and current treatment strategies. Oncologist. 2012; 17(1):46-54.
Cheungpasitporn W, Thongprayoon C, O’corragain OA, Edmonds PJ, Ungprasert P, Kittanamongkolchai W, Erickson SB. The risk of kidney cancer in patients with kidney stones: A systematic review and meta-analysis. QJM. 2015; 108(3):205–212.
Caliskan S, Sungur M, Ozsoy E, Koca O. The renal neoplastic lesions in non-functioning kidney patients who underwent simple nephrectomy. Med Science. 2018; 7(2):247-8
Zengin K, Tanik S, Sener NC, Albayrak S, Ekici M, Bozkurt IH, Bakirtas H, Gurdal M, Imamoglu MA. Incidence of renal carcinoma in non-functioning kidney due to renal pelvic stone disease. Mol Clin Oncol. 2015; 3(4):941–943.
Mouallem N El, Smith SC, Paul AK. Sarcomatoid renal cell carcinoma: Biology and treatment advances. Urol Oncol Semin Orig Investig. 2018;36(6):265–271.
Campbell SC, Lane BR, Pierorazio PM. Malignant Renal Tumors. In: Wein A, Kavoussi L, Campbell M, Walsh P, ClinicalKey, ed. Campbell Walsh Wein Urology. Twelfth Ed. Elsevier Saunders: Philadelphia; 2021
Türk C, Neisius A, Petrik A, Seitz C, Skolarikos A, Thomas K, Davis NF, Donaldson JF, Lombardo R, Grivas N, Ruhayel Y. EAU Guidelines on Urolithiasis. In: EAU Guidelines. European Association of Urology Guidelines Office: Arnhem, The Netherlands; 2020.
Mullins JK, Rodriguez R. Renal cell carcinoma seeding of a percutaneous biopsy tract. Can Urol Assoc J. 2013; 7(3–4):E176-9.
Wang SS, Ho HC, Su CK, Chen WM, Cheng CL, Yang CR. Seeding of malignant renal tumor through a nephrostomy tract. J Chin Med Assoc. 2004; 67(6):308–310.
Bishoff JT, Rastinehad AR. Urinary tract imaging: Basic principles of CT. In: Wein A, Kavoussi L, Campbell M, Walsh P, ClinicalKey, ed. Campbell Walsh Wein Urology. Twelfth Ed. Elsevier Saunders: Philadelphia; 2021.
Ljungberg B, Albiges L, Bedke J, Bex A, Capitanio U, Giles RH, Hora M, Klatte T, Lam T, Marconi L, Powles T, Volpe A, Abu-Ghanem Y, Dabestani S, Fernández-Pello Montes S, Hofmann F, Kuusk T, Tahbaz R. EAU Guidelines on Renal Cell Carcinoma. In: EAU Guidelines. European Association of Urology Guidelines Office: Arnhem, The Netherlands; 2021.
Federico A, Morgillo F, Tuccillo C, Ciardiello F, Loguercio C. Chronic inflammation and oxidative stress in human carcinogenesis. Int J Cancer 2007; 121:2381–6.
Beuselinck B, Lerut E, Wolter P, Dumez H, Berkers J, Van Poppel H, Joniau S, Oyen R, De Wever L, Strijbos M, Paridaens R, Schöffski P. Sarcomatoid dedifferentiation in metastatic clear cell renal cell carcinoma and outcome on treatment with antievascular endothelial growth factor receptor tyrosine kinase inhibitors: A retrospective analysis. Clin Genitourin Cancer. 2014; 12(5):e205–e214.

[1] Shuch B, Bratslavsky G, Linehan WM, Srinivasan R. Sarcomatoid renal cell carcinoma: A comprehensive review of the biology and current treatment strategies. Oncologist. 2012; 17(1):46-54.

[2] Cheungpasitporn W, Thongprayoon C, O’corragain OA, Edmonds PJ, Ungprasert P, Kittanamongkolchai W, Erickson SB. The risk of kidney cancer in patients with kidney stones: A systematic review and meta-analysis. QJM. 2015; 108(3):205–212.

[3] Caliskan S, Sungur M, Ozsoy E, Koca O. The renal neoplastic lesions in non-functioning kidney patients who underwent simple nephrectomy. Med Science. 2018; 7(2):247-8

[4] Zengin K, Tanik S, Sener NC, Albayrak S, Ekici M, Bozkurt IH, Bakirtas H, Gurdal M, Imamoglu MA. Incidence of renal carcinoma in non-functioning kidney due to renal pelvic stone disease. Mol Clin Oncol. 2015; 3(4):941–943.

[5] Mouallem N El, Smith SC, Paul AK. Sarcomatoid renal cell carcinoma: Biology and treatment advances. Urol Oncol Semin Orig Investig. 2018;36(6):265–271.

[6] Campbell SC, Lane BR, Pierorazio PM. Malignant Renal Tumors. In: Wein A, Kavoussi L, Campbell M, Walsh P, ClinicalKey, ed. Campbell Walsh Wein Urology. Twelfth Ed. Elsevier Saunders: Philadelphia; 2021

[7] Türk C, Neisius A, Petrik A, Seitz C, Skolarikos A, Thomas K, Davis NF, Donaldson JF, Lombardo R, Grivas N, Ruhayel Y. EAU Guidelines on Urolithiasis. In: EAU Guidelines. European Association of Urology Guidelines Office: Arnhem, The Netherlands; 2020.

[8] Mullins JK, Rodriguez R. Renal cell carcinoma seeding of a percutaneous biopsy tract. Can Urol Assoc J. 2013; 7(3–4):E176-9.

[9] Wang SS, Ho HC, Su CK, Chen WM, Cheng CL, Yang CR. Seeding of malignant renal tumor through a nephrostomy tract. J Chin Med Assoc. 2004; 67(6):308–310.

[10] Bishoff JT, Rastinehad AR. Urinary tract imaging: Basic principles of CT. In: Wein A, Kavoussi L, Campbell M, Walsh P, ClinicalKey, ed. Campbell Walsh Wein Urology. Twelfth Ed. Elsevier Saunders: Philadelphia; 2021.

[11] Ljungberg B, Albiges L, Bedke J, Bex A, Capitanio U, Giles RH, Hora M, Klatte T, Lam T, Marconi L, Powles T, Volpe A, Abu-Ghanem Y, Dabestani S, Fernández-Pello Montes S, Hofmann F, Kuusk T, Tahbaz R. EAU Guidelines on Renal Cell Carcinoma. In: EAU Guidelines. European Association of Urology Guidelines Office: Arnhem, The Netherlands; 2021.

[12] Federico A, Morgillo F, Tuccillo C, Ciardiello F, Loguercio C. Chronic inflammation and oxidative stress in human carcinogenesis. Int J Cancer 2007; 121:2381–6.

[13] Beuselinck B, Lerut E, Wolter P, Dumez H, Berkers J, Van Poppel H, Joniau S, Oyen R, De Wever L, Strijbos M, Paridaens R, Schöffski P. Sarcomatoid dedifferentiation in metastatic clear cell renal cell carcinoma and outcome on treatment with antievascular endothelial growth factor receptor tyrosine kinase inhibitors: A retrospective analysis. Clin Genitourin Cancer. 2014; 12(5):e205–e214.

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

Abstract

References

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