Renal Leiomyosarcoma
We present the case of 69-year-old woman who was found to have a large left abdominal mass in evaluation for diffuse abdominal pain accompanied by asthenia and nauseas. Non abnormalities were observed in routine laboratory examination, except a ferriprive anemia: hemoglobin 10.8 mg/dL (12-14 mg/dL). A computed tomographic scan imaging demonstrated an 18 cm lesion from the left kidney; no thrombus in renal vein or cava and neither regional lymph nodes or adrenal gland involved were informed (). Open right radical nephrectomy by lumbotomy without lymph adenectomy (intraoperatively no grossly visible lymph nodes were identified) was performed. The surgical specimen revealed a solid multinodular mass measuring 18×15 cm () which probably originates in the renal capsule (). The histopathogical examination demonstrated a renal high-grade leiomyosarcoma, which renal capsule infiltration but without extend over there (), and did not extend to pelvis, renal vein or adrenal gland. All excised hilar fat lymph nodes were free of disease. The immunohistochemical profile with smooth muscle actine was difusely positive (). Focal immunostaining were found for desmin, vimentin and CD117 (KIT). No immunostaining were observed for melan A, HMB-45 and S-100 protein. Adjuvant chemo therapy was not performed based upon not data in survival benefit. Five years after the operation, she was in good health with no sign of recurrence or metastases.