Diagnosis experience of sarcomatoid renal cell carcinoma
10.3760/cma.j.issn.1000-6702.2016.07.002
- VernacularTitle:肉瘤样肾细胞癌的诊治经验
- Author:
Shen WANG
;
Chenming ZHAO
;
Zhiqiang CHEN
- Publication Type:Journal Article
- Keywords:
Sarcomatoid renal cell carcinoma;
Sarcomatoid differentiation;
Ki-67 labeling index
- From:
Chinese Journal of Urology
2016;37(7):485-487
- CountryChina
- Language:Chinese
-
Abstract:
Objective Explore the diagnosis experience of sarcomatoid renal cell carcinoma (SRCC).Method There were 5 cases of SRCC from April 2011 to June 2013,3 of them were females and 2 were males,with a mean age of 49 (27-71).All the patients were presented with pain accompanied with other symptoms such as hematuria,fever and polyuria.CT urography suggested renal occupied lesions,withuneven density and enhancement,and malignancy was highly suspected.The mean diameter of tumors was 9.2 cm(4-18 cm).Radical nephrectomy was performed on all patients,tumors were located in renal parenchymal,and with adherence to other tissues.One patient with lung metastasis was found before surgery.Result Pathologic findings of the resected tissues after operation noted SRCC.Under the microscope,a large number of spindle shaped cells were seen,and Vimentin and PCK were all positive in immunohistochemical.Three patients with metastases were found after surgery (adrenal gland,liver,pancreas).Postoperative pathological stages were one T2N0M1,three T4N0M1 and one T3N0M0.One patient received IL-2 immunotherapy.All patients died within 9 months after surgery with a median survival of 3.8 months.Immunohistochemistry in the postoperative,there were four patients with the level of Ki-67 LI ＞ 50％,with distant metastasis and survival time was 1-4 moths.Conclusion The disease develops rapidly,and the prognosis of the patients is very poor.The Ki-67 LI may be considered as a prognosis marker and the patients with sarcomatoid differentiation can benefit little from surgery alone.
