Renal clear cell sarcoma presenting as a spontaneous renal hematoma: A rare presentation

Abstract

Clear cell sarcoma of the kidney (CCSK) is an uncommon renal neoplasm of childhood. It represents between 2% and 9% of all pediatric renal tumors, and generally arises before the age of 5 years. It often mimics other pediatric renal tumors. Presently described is the case of a 7-year-old girl who presented with complaints of vomiting and abdominal pain. Abdominal ultrasonography revealed a right renal mass, and the patient developed a renal hematoma a few hours after admission. The patient underwent a nephroureterectomy with a provisional diagnosis of Wilms tumor; however, histopathological examination of a specimen revealed CCSK. CCSK is similar to Wilms tumor in terms of the typical age of appearance and clinical and histopathological features, but the treatment method and prognosis are different. Therefore, the differential diagnosis is very important. This case was presented to draw attention to a rare presentation of clear cell sarcoma. CCSK should be kept in mind in the differential diagnosis of a renal mass.

Keywords: Clear cell sarcoma; child; hematoma; kidney.

Figure 1

The macroscopic appearance of the mass palpated on physical examination.

Figure 2

The abdominal tomography image of right renal mass and hematoma.

Figure 3

The macroscopic appearance of the mass.

Figure 4

The microscopic appearance of clear cell sarcoma composed of epitheloid cells with pale cytoplasm and indistinct nucleoli separated by a clear extracellular matrix (hematoxylin-eosin ×400).