Case Reports

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

Faridz Albam Wiseso
Division of Urology, Department of Surgery, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia

Raden Danarto
Division of Urology, Department of Surgery, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/ Dr. Sardjito Hospital, Yogyakarta, Indonesia. Email: dr.danarto@yahoo.co.id

Hanggoro Tri Rinonce
Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/ Dr. Sardjito Hospital, Yogyakarta, Indonesia

Nita Sahara
Department of Anatomical Pathology, Faculty of Medicine, Universitas Malahayati, Lampung, Indonesia

Dewa Nyoman Murti Adyaksa
Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/ Dr. Sardjito Hospital, Yogyakarta, Indonesia

Yana Supriatna
Department of Radiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/ Dr. Sardjito Hospital, Yogyakarta, Indonesia
Online First: October 27, 2021 | Cite this Article
Wiseso, F., Danarto, R., Rinonce, H., Sahara, N., Adyaksa, D., 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. DOI:10.15562/ijbs.v15i2.350


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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