A 75-year-old woman with a history of uterine fibroids, hyperlipemia, hypertension, hypertensive heart disease with chronic atrial fibrillation and right carotid stroke presented with left flank pain and hematuria.
The imaging study showed a large retroperitoneal tumor that extended to the left hypochondrium and void of about 22 cm, solid, multilobulated, with abundant calcifications inside with heterogeneous uptake of intravenous contrast.
The lesion seemed to contact the ipsilateral kidney without affecting the excretory system in terms of functionality, although stretching and compression existed; with these data surgical excision of the lesion was performed.
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A solid tumor of 2000 g was received, measuring 24 x 14 x 12 cm in maximum dimensions. The kidney surface showed a multinodular aspect of diameter in one of its poles a fragment of 4 cm.
When the tumor was cut, it was made up of a white piece of clothing in which the breast was randomly distributed into several necrotic areas of different size.
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The histological study showed a mesenchymal component organized as bands of spindle cells intertwined with a 'spinous pattern' with nuclei in the form of 'pure cigarro' with a clear epithelial conduit.
Histochemical study showed immunopositivity of the epithelial component for keratins and mesenchymal component for vimentin, actin and CD34.
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Twenty days later she developed deep venous thrombosis in the left lower limb with pulmonary thromboembolism resolved in the ICU.
Ten months later, the patient underwent FNAB for a nodular peritoneal lesion identified during an abdominal ultrasound included in the follow-up protocol for the neoplasm; in this case, a small spindle cell carcinoma with no recurrence was identified.
After twelve months of follow-up there was a new admission to vomits, diarrhea and worsening of the general condition of the patient being objectified irreversible intestinal occlusion and ill-occlusion due to exitus during the same hospitalization.
