Bian Lihui, Duan Jingling, Wang Xiaoyu, Yang Yang, Zhang Xiaoling, Xiao Shengjun
Department of Pathology, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China (mainland).
Department of Physiology, Faculty of Basic Medical Sciences, Guilin Medical University, Guilin, Guangxi, China (mainland).
Am J Case Rep. 2019 Aug 19;20:1225-1230. doi: 10.12659/AJCR.916651.
BACKGROUND Sarcomatoid renal cell carcinoma is not a distinct histologic entity transformed from different subtypes of renal cell carcinoma. The sarcomatoid transformation was accepted as the result of dedifferentiation of the primary tumor. Here we present a case of sarcomatoid chromophobe renal cell carcinoma and review the clinicopathological characteristics of sarcomatoid chromophobe renal cell carcinoma. CASE REPORT A 63-year-old female complained of painless gross hematuria for 3 months. Routine urine test showed that urinary protein was ++ and white blood cells were +++; serum CA153 was moderately elevated at 71.08 U/mL (normal <28 U/mL). Ultrasonography and a computed tomography scan showed a mass in the lower pole of the right kidney, measuring 13.4×15.4×11.4 cm. She underwent a right radical nephrectomy with lymph nodes dissection under general anesthetic. There was no evidence of recurrence and lymphadenopathy 12 months after surgery. CONCLUSIONS Sarcomatoid chromophobe renal cell carcinoma is an uncommon tumor characterized by a biphasic tumor with both classical epithelial components and sarcomatoid components. The prognosis of sarcomatoid chromophobe renal cell carcinoma is worse than classical chromophobe renal cell carcinoma. It is important to recognize that sarcomatoid change of chromophobe renal cell carcinoma has the potential to behave aggressively and to metastasize.
背景 肉瘤样肾细胞癌并非由肾细胞癌的不同亚型转变而来的独特组织学实体。肉瘤样转变被认为是原发性肿瘤去分化的结果。在此，我们报告一例肉瘤样嫌色肾细胞癌病例，并回顾肉瘤样嫌色肾细胞癌的临床病理特征。病例报告 一名63岁女性主诉无痛性肉眼血尿3个月。尿常规检查显示尿蛋白++，白细胞+++；血清CA153中度升高，为71.08 U/mL（正常<28 U/mL）。超声检查和计算机断层扫描显示右肾下极有一肿块，大小为13.4×15.4×11.4 cm。她在全身麻醉下接受了右肾根治性切除术及淋巴结清扫术。术后12个月无复发及淋巴结病证据。结论 肉瘤样嫌色肾细胞癌是一种罕见肿瘤，其特征为具有经典上皮成分和肉瘤样成分的双相性肿瘤。肉瘤样嫌色肾细胞癌的预后比经典嫌色肾细胞癌差。认识到嫌色肾细胞癌的肉瘤样改变有潜在的侵袭性和转移能力很重要。
