Chen Chien-Chin, Liao Kai-Sheng
Department of Pathology, Ditmanson Medical Foundation, Chiayi Christian Hospital, Chiayi, Taiwan.
Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
Tzu Chi Med J. 2019 Apr-Jun;31(2):129-132. doi: 10.4103/tcmj.tcmj_194_18.
We present a case of a 22-year-old female with gross hematuria for 1 month. A 9.5-cm tumor was found at her left kidney. On suspicion of a renal cancer, she received left nephrectomy. Histologically, it was a hypercellular tumor with undifferentiated anaplastic neoplastic cells in fascicular sheets intermixed with chondroid nodules. The differential diagnoses included anaplastic sarcoma of the kidney (ASK), anaplastic Wilms tumor, mesenchymal chondrosarcoma, sarcomatoid renal cell carcinoma, clear cell sarcoma of the kidney, rhabdoid tumor of the kidney, congenital mesoblastic nephroma, and synovial sarcoma. Based on the results of the work-up and literature review, ASK was diagnosed. The postoperative recovery was uneventful, and the patient began adjuvant chemotherapy (Ifosfamide [1800 mg/m] and Epirubicin [60 mg/m]) 5 weeks after the operation. Herein, we present this case to share the experience on an extremely rare entity.
我们报告一例22岁女性，肉眼血尿1个月。在其左肾发现一个9.5厘米的肿瘤。因怀疑为肾癌，她接受了左肾切除术。组织学检查显示，这是一个细胞增多的肿瘤，有未分化的间变肿瘤细胞呈束状排列，并夹杂软骨样结节。鉴别诊断包括肾间变性肉瘤（ASK）、间变性威尔姆斯瘤、间叶性软骨肉瘤、肉瘤样肾细胞癌、肾透明细胞肉瘤、肾横纹肌样瘤、先天性中胚层肾瘤和滑膜肉瘤。根据检查结果及文献复习，诊断为ASK。术后恢复顺利，患者在术后5周开始辅助化疗（异环磷酰胺[1800毫克/平方米]和表柔比星[60毫克/平方米]）。在此，我们呈现此病例以分享关于这一极其罕见疾病的经验。
