Korean J Urol.  2009 Aug;50(8):812-815. 10.4111/kju.2009.50.8.812.

Sarcomatoid Urothelial Carcinoma of the Renal Pelvis with Extremely Aggressive Clinical Behavior

• Paick SH
• Yoon SW
• Baek M
• Lim SD
• Lho YS
• Kim HG

• KMID: 1780487
• DOI: http://doi.org/10.4111/kju.2009.50.8.812

Abstract

Sarcomatoid urothelial carcinoma is a rare malignancy with a poor prognosis. We experienced a case of sarcomatoid urothelial carcinoma of the renal pelvis with extremely aggressive clinical behavior. An 81-year-old woman underwent a laparoscopic radical nephroureterectomy to remove a 4.5x3.1 cm sized localized left renal pelvis mass. The mass was pathologically confirmed as a sarcomatoid urothelial carcinoma. Although the operation was successful, the patient died 2 months postoperatively with widely metastatic disease.

Keyword

Kidney pelvis; Carcinoma

MeSH Terms

Aged, 80 and over
Female
Humans
Kidney Pelvis
Prognosis

Figure

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  Fig. 1 Abdominal computed tomography shows a well-enhancing left renal pelvis mass.

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  Fig. 2 Microscopic findings of the specimen. (A) Neoplastic spindle cells arising from a high-grade urothelial carcinoma (H&E, ×400). (B) Sarcomatoid spindle cells in a fascicular arrangement (H&E, ×200).

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  Fig. 3 Immunohistochemical findings of the specimen. (A) Cytokeratin stain shows positive reactions in the sarcomatoid spindle cells (cytokeratin stain, ×400). (B) Vimentin stain shows strong expression of vimentin in the sarcomatoid spindle cells (vimentin stain, ×200).

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  Fig. 4 Chest radiography shows multiple small nodules suspicious of a metastatic tumor in the whole lung field.

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