Rhabdoid tumor of the kidney with spontaneous rupture: case report and review of literature.

Spontaneous rupture of the kidney is uncommon; here we report a case of spontaneous rupture of the kidney due to a rhabdoid tumor. An 11-year-old boy presented with left flank pain and hematuria, was admitted to a hospital where he was found to have an abnormality of the left kidney on computed tomography (CT) scan. He was referred to our department for further evaluation and treatment on the next day. Spontaneous rupture of left renal tumor was suspected by a drop in hemoglobin level, hemoglobin decreased from 9.2 to 7.6 mg/dl within 72 h. The hemoglobin level continued to drop despite blood transfusion. Urgent trans-abdominal exploration of the left kidney was performed. During the operation, rupture of left renal tumor with massive bleeding was noted. Para-aortic lymph node metastasis is evident. The surgical specimen contained a large peri-renal hemorrhage and tumor rupture into peri-pelvic soft tissue. Histopathological diagnosis was rhabdoid tumor consisting of round nuclei, prominent nucleoli and eosinophic cytoplasm. Two courses of adjuvant chemotherapy with actinomycin D, vincristine and epirubicin and radiotherapy (1,200 cGY) were performed post-operatively. The patient died 5 months after operation due to metastasis of the tumor to the lung and intra-abdominal organs.