A Rare Case of Sarcomatoid Renal Cell Carcinoma in a Young Adult Patient

• Published in: Research and reports in urology 2022-06, Vol.14, p.241-245
• Main Authors: Warli, Syah Mirsya, Andy, Andy, Mariedina, Causa Trisna, Nasution, Ramlan, Kadar, Dhirajaya Dharma
• Format: Article
• Language: English
• Subjects: Case Report; flank; poor prognosis; renal cell carcinoma; sarcomatoid differentiation
• ISSN: 2253-2447; 2253-2447
• DOI: 10.2147/RRU.S370975

Syah Mirsya Warli,1 Andy Andy,2 Causa Trisna Mariedina,3 Ramlan Nasution,2 Dhirajaya Dharma Kadar2 1Department of Urology, Universitas Sumatera Utara Hospital – Universitas Sumatera Utara, Medan, Indonesia; 2Division of Urology, Department of Surgery, Haji Adam Malik General Hospital – Universitas Sumatera Utara, Medan, Indonesia; 3Department of Anatomical Pathology, Universitas Sumatera Utara, Medan, IndonesiaCorrespondence: Syah Mirsya Warli, Department of Urology, Universitas Sumatera Utara Hospital – Universitas Sumatera Utara, Medan, Indonesia, Tel [phone], Email [e-mail]: Sarcomatoid differentiation is a rare condition that could present in different subtypes of renal cell carcinomas (RCCs) and is associated with a significantly poor prognosis. Sarcomatoid renal cell carcinoma (SRCC) patients are typically aged between 54 and 63, with a male-to-female ratio ranging from 1.3:1 to 2:1. Here, we report a case of SRCC in a 29-year-old female patient.Case Presentation: A 29-year-old female presented with left flank pain. A large lump was palpated on left flank and there was costovertebral angle tenderness. The lump was enlarged, and the patient also suffered from anemia. Abdominopelvic CT demonstrated solid mass with an internal gliosis in the left part of the renal cortex and the solid component was enhanced with contrast admission. Then, the patient underwent left radical nephrectomy with wide perirenal excision and paraaortic lymph nodes resection. Histopathological examination revealed SRCC with no lymphovascular invasion.Conclusion: The scarcity of data on SRCCs emphasizes the need for ongoing research into the biology, diagnostics, and effective treatment options for patients with this disease, as responses to conventional therapies have been disappointing, leaving patients with few options. Cytoreductive nephrectomy for SRCC patients with metastatic disease is debatable, although some research suggests resection at any stage in patients with good performance status. In this case, radical nephrectomy was performed and there was no evidence of metastasis.Keywords: flank, poor prognosis, renal cell carcinoma, sarcomatoid differentiation