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Case Reports
. 2011 May;3(2):110-3.
doi: 10.4103/0974-7796.82182.

Primary renal synovial sarcoma

Vandana U Grampurohit  1 , Aneel Myageri, Ravikala V Rao
Affiliations
Case Reports

Primary renal synovial sarcoma

Vandana U Grampurohit et al. Urol Ann. 2011 May.

Abstract

Primary synovial sarcoma (SS) of kidney is very rare and difficult to diagnose. Here, we present a case of a 21-year-old female clinically diagnosed as renal cell carcinoma. Right nephrectomy specimen showed a cystic tumor in the upper pole of kidney with areas of hemorrhage and solid growth. Histologically, it showed poorly differentiated cells with hemangiopericytoma-like vascular pattern. Morphologic and immunohistochemical features were compatible with the diagnosis of poorly differentiated SS of kidney. Primary renal SS is a recently described entity. To the best of our knowledge, approximately 34 cases have been reported till date and this is the eighth documented case of poorly differentiated variant. Most of the time, poorly differentiated SS of kidney exhibits hemangiopericytoma like histology. Reverse transcriptase-polymerase chain reaction analysis to demonstrate SYT-SSX fusion gene transcript helps to confirm the diagnosis.

Keywords: Kidney; poorly differentiated; synovial sarcoma.

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Conflict of interest statement

Conflict of Interest: None.

Figures

Figure 1
Figure 1
(a and b) Abdominal CT showing well marginated soft tissue mass arising in the upper pole of right kidney
Figure 2
Figure 2
Grossly, yellow-brown tan mass in the upper pole in welldefined cystic space
Figure 3
Figure 3
The tumor shows solid sheets of plump spindle cells with high N:C ratio, pleomorphism and frequent mitoses. The inset shows the clear cell change in tumor cells (H and E, ×40)
Figure 4
Figure 4
Tumor showing hemangiopericytoma-like vascular pattern (H and E, ×40)
Figure 5
Figure 5
Immunohistochemical study of tumor cells showing (a) diffuse positivity for BCl-2; (b) focal positivity for EMA; (c) strong positivity for CD99; and (d) negativity for CD34
See this image and copyright information in PMC

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