Sarcomatoid carcinoma of the renal pelvis: A case report

Abstract

Sarcomatoid carcinoma is a high-grade malignant neoplasm which exhibits morphological and/or immunohistochemical evidence of bidirectional epithelial and mesenchymal differentiation. Sarcomatoid carcinoma occurring in the upper urinary tract is rare. The present study reports a case of primary sarcomatoid carcinoma of the renal pelvis. A 49-year-old female patient was admitted to Beijing Chao-Yang Hospital for experiencing two weeks of intermittent hematuria. A computed tomography scan revealed a mass of 2 cm in diameter in the left renal pelvis. A retroperitoneoscopic nephroureterectomy combined with a bladder cuff excision was performed, and the final pathological diagnosis was sarcomatoid carcinoma of the renal pelvis. The patient did not receive systemic chemotherapy and radiotherapy. Regular follow-up was performed for 30 months, and there was no evidence of tumor local recurrence or distant metastasis.

Keywords: renal pelvis; sarcomatiod carcinoma; urothelial tumor.

Figure 1

Abdominal computed tomography scan demonstrates a mass in the left renal pelvis.

Figure 2

Photomicrographs of the tumor specimen. (A) The sarcomatous area is mainly composed of pleomorphic spindle, round and giant cells (stain, hematoxylin and eosin; magnification, ×200). (B) The transitional cell carcinoma component and the sarcomatoid tumor cells are immunoreactive for cytokeratin (immunostaining; magnification, ×100). (C) Sarcomatoid cells demonstrate positive expression of cytokeratin (immunostaining; magnification, ×200). (D) Vimentin is strongly expressed in the sarcomatoid area (immunostaining; magnification, ×200).