Yoshida Kazuhiko, Ito Fumio, Nakazawa Hayakazu, Maeda Yoshiko, Tomoe Hikaru, Aiba Motohiko
Department of Urology.
Rare Tumors. 2009 Dec 28;1(2):e28. doi: 10.4081/rt.2009.e28.
A 78-year old man was diagnosed with a left bleeding renal cyst from CT scan results. Serial CT scans revealed the left kidney mass to be increasing in size and a new lesion in the liver. Renal cell carcinoma with liver metastasis was diagnosed and a radical nephrectomy performed. The initial pathological diagnosis was a benign chronic hematoma. However, the liver mass increased in size and multiplied, while another mass emerged in the twelfth thoracic vertebra with spinal paralysis and was immediately removed. Pathological findings for that specimen showed malignancy of stromal cell origin but low atypia. The renal specimen was re-evaluated using whole cross-section analysis and immunohistochemistry, and diagnosed as a primary renal angiosarcoma. Recombinant interleukin-2 therapy was started immediately; however, the patient died of metastatic disease 13 months after the initial operation. Although contrast imaging depicted the primary lesion as a non-specific hematoma with little focal pooling, and low-grade cytological atypia was shown pathologically, the angiosarcoma was extremely aggressive.
一名78岁男性经CT扫描结果诊断为左肾出血性囊肿。系列CT扫描显示左肾肿物大小增大，肝脏出现新病灶。诊断为肾细胞癌伴肝转移，并进行了根治性肾切除术。最初的病理诊断为良性慢性血肿。然而，肝脏肿物大小增大且数量增多，同时第十二胸椎出现另一个肿物并伴有脊髓麻痹，随即进行了切除。该标本的病理检查结果显示为基质细胞来源的恶性肿瘤，但异型性低。对肾标本进行全断面分析和免疫组化重新评估，诊断为原发性肾血管肉瘤。立即开始重组白细胞介素-2治疗；然而，患者在初次手术后13个月死于转移性疾病。尽管对比成像将原发性病变描述为非特异性血肿，几乎没有局灶性造影剂潴留，且病理显示为低度细胞学异型性，但血管肉瘤极具侵袭性。
