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Review
. 2022 Aug 1;16(1):295.
doi: 10.1186/s13256-022-03489-2.

Clear cell sarcoma of the kidney with inferior vena cava thrombus: a case report

Leen Jamel Doya  1 , Khaled Alyousef  2 , Majdy Oukan  2 , Ali Razzok  2 , Basel Shek Alshabab  2 , Tarek AlEid  2 , Rabab Saloum  3 , Hassan Nasser  2
Affiliations
Review

Clear cell sarcoma of the kidney with inferior vena cava thrombus: a case report

Leen Jamel Doya et al. J Med Case Rep. .

Abstract

Background: Clear cell sarcoma of the kidney is an uncommon pediatric renal malignant neoplasm that is typically characterized in 2-3-year-olds by aggressive behavior and late relapses. Our literature review revealed fewer than ten previously reported cases of CCSK with inferior vena cava thrombus, with only five in the pediatric age group.

Case presentation: We report the case of a 14-year-old Syrian girl who complained of mild pain in the left lumbar region pain with hematuria. On physical examination, a mass was palpated in the left flank. Abdominal ultrasonography revealed a left renal mass (7 × 5 × 2 cm3), associated with dilatation of the left renal vein. Contrast abdominal computed tomography showed a mass measuring 7 × 5 × 3 cm3 with the presence of thrombus extending into the inferior cavity down to the right atrium that was initially diagnosed as Wilms' tumor. Radical right nephrectomy with excision of the thrombus was undertaken. Histological immunostaining revealed a diagnosis of the tumor as clear cell sarcoma with vascular tumor thrombus extending to the inferior vena cava.

Conclusion: Clear cell sarcoma and Wilms' tumor are similar in terms of typical age of appearance, clinical features, and histopathology, but with different methods of treatment and prognosis. The differential diagnosis of such masses is thus very important. We present the case of a patient with clear cell sarcoma with unusual age, with complete removal of the thromboses in the inferior vena cava and the right atrium.

Keywords: Clear cell sarcoma of the kidney; Hematuria; Vascular tumor thrombus.

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Conflict of interest statement

All of the authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Computed tomography (CT) scan of the abdomen showing a 7 × 5 × 3 cm3 mass arising from the anterior part of the left kidney with tumor thrombus in the inferior vena cava extending to the right atrium without metastases. b CT scan of the abdomen with reconstruction
Fig. 2
Fig. 2
a Immunohistopathology of resected renal mass revealed vimentin positivity. b Immunohistopathology of the resected renal mass revealed negative cytokeratin
See this image and copyright information in PMC

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