Martínez-Cornelio A, Ramos-Salgado F, Hernández-Ramírez D, García-Álvarez KG, Alvarado-Cabrero I, Hernández-Toriz N

Language: Spanish
References: 22
Page: 282-285
PDF size: 338.92 Kb.

ABSTRACT

Background: Renal sarcomas represent 1-2% of malignant kidney tumors in adults; 50% of renal sarcomas are composed of leiomyosarcomas. These tumors generally arise from the renal capsule, smooth muscle tissue of the renal pelvis and intrarenal vessels. They are indistinguishable from other renal masses prior to surgery and are associated with an adverse prognosis.
Clinical case: We report the case of a 58-year-old female with a clinical course characterized by asthenia, weakness, generalized attack to her health status and pain in the left renal fossa. Computed axial tomography was performed where a left retroperitoneal tumor was diagnosed. Left radical nephrectomy was performed. The histopathology report demonstrated leiomyosarcoma originating from the renal sinus vessels. The patient was successfully treated with adjuvant radiotherapy.
Conclusions: Renal leiomyosarcomas usually have an aggressive biological behavior with poor prognosis, accounting for surgical treatment with wide resection associated with adjuvant chemotherapy and radiotherapy as the only therapeutic option.

REFERENCES

1. Deyrup AT, Montgomery E, Ficher C. Leiomyosarcoma of the kidney: a clinicopathologic study. Am J Surg Pathol 2004;28:178-182.

2. Sharma D, Pradhan S, Aryya NC, Shukla VK. Leiomyosarcoma of kidney: a case report with long term results after radiotherapy and chemotherapy. Int Urol Nephrol 2007;39:397-400.

3. Demir A, Yazici CM, Eren F, Türkeri L. Case report: good prognosis in leiomyosarcoma of the kidney. Int Urol Nephrol 2007;39:7-10.

4. Rakowsky E, Barzilay J, Schujman E, Servadio C. Leiomyosarcoma of kidney. Urology 1987;29:68-70.

5. Moazzam M, Ather MH, Jussainy AS. Leiomyosarcoma presenting as a spontaneously ruptured renal tumor—case report. BMC Urol 2002;19:13.

6. Ochiai K, Onitsuka H, Honda H, Kawamoto K, Uozumi J, Kumazawa J, et al. Leiomyosarcoma of the kidney: CT and MR appearance. J Comput Assist Tomogr 1993;17:656-658.

7. Guillou L, Coindre JM, Bonichon F, Nguyen BB, Terrier P, Collin F, et al. Comparative study of the National Cancer Institute and French Federation of Cancer Centers Sarcoma Group grading systems in a population of 410 adult patients with soft tissue sarcoma. J Clin Oncol 1997;15:350-362.

8. Fernández De Sevilla T, Muñiz R, Palou J, Banús JM, Alegre J, García A, et al. Renal leiomyosarcoma in a patient with tuberous sclerosis. Urol Int 1988;43:62-64.

9. Kendal WS. The comparative survival of renal leiomyosarcoma Can J Urol 2007;14:3435-3442.

10. Miller JS, Zhou M, Brimo F, Guo C, Epstein J. Primary leiomyosarcoma of the kidney: a clinicopathologic study of 27 cases. Am J Surg Pathol 2010;34:238-242.

11. Kadikoy H, Haque WM, Topkara VK, Frome AI, Hayes TG. Bilateral leiomyosarcoma of the kidney with family history of kidney cancer. Can J Urol 2009;16:4847-4849.

12. King ME, Dickersin GR, Scully RE. Myxoid leiomyosarcoma of the uterus: a report of six cases. Am J Surg Pathol 1982;6:589-598.

13. Weiss SW. Smooth muscle tumors of soft tissue. Adv Anat Pathol 2002;9:351-359.

14. Miettinen MM, Sarlomo-Rikala M, Kovatich AJ, Lasota J. Calponin and H-caldesmon in soft tissue tumors: consistent H-caldesmon inmunoreactivity in gastrointestinal stromal tumors indicates traits of smooth muscle differentiation. Mod Pathol 1999;12:756-762.

15. de Peralta-Venturina M, Moch H, Amin M, Tamboli P, Hailemariam S, Mihatsch M, et al. Sarcomatoid differentiation in renal cell carcinoma: a study of 101 cases. Am J Surg Pathol 2001;25:275-284.

16. Brown DC, Theaker JM, Banks PM, Gatter KC, Mason DY. Cytokeratin expression in smooth muscle and smooth muscle tumors. Histopathology 1987;11:477-486.

17. Chonko AM, Weiss SM, Stein JH, Ferris TF. Renal involvement in tuberous sclerosis. Am J Med 1974;56:124-132.

18. Eble JN, Angiomyolipoma of kidney. Semin Diagn Pathol 1998;15:21-40.

19. Makhlouf HR, Ishak KG, Shekar R, Sesterhenn IA, Young DY, Fanburg-Smith JC. Melanoma markers in angiomyolipoma of the liver and kidney: a comparative study. Arch Pathol Lab Med 2002;126:49-55.

20. Lehnhardt M, Muehlberger T, Kuhnen C, Brett D, Steinau HU, Jafari HJ, et al. Feasibility of chemosensitivity testing in soft tissue sarcomas. World J Surg Oncol 2005;3:20.

21. Youssef E, Fontanesi J, Mott M, Kraut M, Lucas D, Mekhael H, et al. Long-term outcome of combined modality therapy in retroperitoneal and deep-trunk soft-tissue sarcoma: analysis of prognostic factors. Int J Radiat Oncol Biol Phys 2002;54:514-519.

22. Maki RG. Gemcitabine and docetaxel in metastatic sarcoma: past, present and future. Oncologist 2007;12:999-1006.