A 20-year-old patient presented to the emergency department with low back pain and fever.
The patient underwent urocultive and hemocultive tests, and the study of tumor markers (negative tests) by computed tomography (CT) detected a tumor mass affecting the upper pole of the right kidney.
After which surgical resection of the tumor was performed.
1.
The surgical resection specimen consisted of a tumor mass of 14 cm in greatest diameter, with intact upper pole and middle segment, and sinus and renal system foot-local affectation.
Lymphatic vascular invasion was observed in the renal tissue and adjacent fat.
Medullary metastases of adrenal gland, invasion of perirenal fat and nodules of the interaortic vena cava chain.
Median performance of immunohistochemical techniques on paraffin sections with different monoclonal antibodies (Dako) was found the following staining pattern compatible with a desmoplastic small, round-shaped actin + gliotypic tumor (S-100).
1.
We also performed a cytogenetic study of the translocation t(11;22) (p13;q12) involving the genes EWS1 and WT1 Brerange by fluorescence in situ hybridization kit (FISH).
This consists of a mixture of two probes that completely flank the locus of the EWS1 gene, the most centromeric probe is marked with tapering-Orange and the most telomerericaentrument.
As a result of this design, any translocation in which the EWS1 locus is involved produces the separation of the red-green fusion signal into a red and a green signal.
The pattern observed in our case corresponds to the normal pattern, with the presence of two signs of red-green fusion by each tumor cell, thus confirming the absence of translocation in the patient.
1.
The patient was treated with three cycles of CAV, four cycles of Ifosfamide/VP-16, and subsequently CTX, ADR, and VCR.
As a result of this treatment, bone marrow tumor is not detected.
However later it was detected by CT tumor recurrence and liver metastasis.
After which there was no response to treatment and the patient died two years after the initial diagnosis.
