原发性肾平滑肌肉瘤病例报告及文献复习

Sunil V. Jagtap, Shubham S. Jagtap, Kaushiki Varshney, Y. Jadhav, P. Shah
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摘要

摘要肾脏平滑肌肉瘤是一种极为罕见的恶性肿瘤。在临床表现和放射影像学上,对其进行准确的术前诊断具有挑战性。在我们的病例中,一名59岁的女性表现为左侧腰痛,间歇性血尿和体重下降,持续6个月。她是已知的高血压和糖尿病病例,20年,定期治疗。腹部-骨盆超声显示外生性皮质肿块,大小为4.0 x 3.8 cm。腹部和骨盆的磁共振成像(平片)显示左肾前皮质极间区有一个轮廓清晰的非包膜外生实性肿块,大小为4.3 x 4 x 4.5 cm。没有任何区域或远处转移的证据。病人接受左肾根治性切除术。组织病理学报告为肾平滑肌肉瘤。免疫组化示平滑肌肌动蛋白弥漫性阳性,desmin局部阳性。我们在此回顾罕见的原发性肾脏平滑肌肉瘤的临床表现、影像学表现和病理特征。
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Primary Renal Leiomyosarcoma: Case Report and Review of the Literature
Renal leiomyosarcoma is an extremely rare malignant tumor. On clinical presentation and radio imaging it is challenging to make an accurate preoperative diagnosis. In our case, a 59-year-old female presented with history of left-sided flank pain, intermittent hematuria and weight loss of 6 months duration. She was known case of hypertension and diabetes mellitus of 20 years and on regular treatment. On the abdomino-pelvis sonography showed an exophytic cortical mass lesion measuring 4.0 x 3.8 cm lesion. Magnetic resonance imaging abdomen and pelvis (plain) shows a well defined non encapsulated exophytic predominantly solid mass lesion measuring 4.3 x 4 x 4.5 cm is noted in the anterior cortex of left kidney at interpolar region. There was no evidence of any regionalor distant metastesis. Patient underwent left radical nephrectomy. On histopathology reported as renal leiomyosarcoma. Immuhistochemistry showed smooth muscle actin diffusely and desmin focally positive. We present this review of rare case of primary renal leiomyosarcoma for its clinical presentation, radiographic findings, and pathologic features.
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