Hata Chiina, Fukawa Yuki, Motoi Toru, Kinowaki Yuko, Akashi Takumi, Ohashi Kenichi, Ishikawa Yudai, Waseda Yuma, Fujii Yasuhisa, Kakuta Ryota, Ikeda Sadakatsu, Onishi Iichiroh
Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
Diagnostics (Basel). 2023 Feb 16;13(4):752. doi: 10.3390/diagnostics13040752.
Giant cell tumor of soft tissue (GCTST) is a defined disease entity that has a morphology similar to giant cell tumor of bone (GCTB). The malignant transformation of GCTST has not been reported, and a kidney primary is extremely rare. We report the case of a 77-year-old Japanese male, who was diagnosed with primary GCTST of the kidney and showed peritoneal dissemination, considered to be a malignant transformation of GCTST, in 4 years and 5 months. Histologically, the primary lesion showed characteristics of round cells with not prominent atypia, multi-nucleated giant cells, and osteoid formation, and carcinoma components were not found. The peritoneal lesion was characterized by osteoid formation and round to spindle-shaped cells, but differed in nuclear atypia, and multi-nucleated giant cells were not detected. Immunohistochemical and cancer genome sequence analysis suggested these tumors were sequential. This is a first report of a case that we could diagnose as primary GCTST of the kidney and could be determined as malignant transformation of GCTST in the clinical course. Analysis of this case will be examined in the future when genetic mutations and the disease concepts of GCTST are established.
软组织巨细胞瘤(GCTST)是一种明确的疾病实体,其形态与骨巨细胞瘤(GCTB)相似。GCTST的恶性转化尚未见报道,肾脏原发性GCTST极为罕见。我们报告一例77岁日本男性病例,其被诊断为肾脏原发性GCTST,并在4年5个月时出现腹膜播散,考虑为GCTST的恶性转化。组织学上,原发灶表现为圆形细胞特征,无异型性显著,有多核巨细胞和类骨质形成,未发现癌成分。腹膜病灶以类骨质形成和圆形至梭形细胞为特征,但核异型性不同,未检测到多核巨细胞。免疫组化和癌症基因组序列分析提示这些肿瘤具有连续性。这是首例我们能够诊断为肾脏原发性GCTST且在临床过程中可确定为GCTST恶性转化的病例报告。当GCTST的基因突变和疾病概念确立后,未来将对该病例进行分析。