case_images: PMC8422535_01
case_images: A CT scan of the abdomen and pelvis shows 10 x 11.2 x 18.7 cm right large subcapsular, perirenal and retroperitoneal haematoma compressing and exerting mass effect on the kidney with a cortical defect at the lower pole with adjacent 2 cm dense foci.
case_images: JKCVHL-8-001-g001.jpg
case_images: PMC8422535_01_JKCVHL-8-001-g001.jpg
case_images: F1
case_images: A computed tomography (CT) scan of the abdomen and pelvis showed a 10 x 11.2 x 18.7 cm right large subcapsular, perirenal, and retroperitoneal haematoma compressing and exerting a mass effect on the kidney with a cortical defect at the lower pole with adjacent 2 cm dense foci (Figure 1).
case_images: MRI of the abdomen shows there is a completely exophytic 3.8 x 8.5 cm soft tissue mass arising from the right inferolateral renal cortex and confined to the perinephric space with new angiogenesis without sinus fat or collecting system invasion, and no regional lymph nodes or renal vein invasion. No intra-abdominal metastasis.
case_images: JKCVHL-8-001-g002.jpg
case_images: PMC8422535_01_JKCVHL-8-001-g002.jpg
case_images: F2
case_images: No intra-abdominal metastasis (T3-N0-M0) was observed (Figure 2).
case_images: The histopathology sections show an infiltrative spindle cell tumour with haemangiopericytoma-like blood vessels with little intervening stroma arranged in fascicular and storiform patterns. The cells are monotonous with scant amphophilic cytoplasm, ovoid to spindled vesicular nuclei with evenly dispersed chromatin and inconspicuous nuclei with mitotic rate of 3/HPF.
case_images: JKCVHL-8-001-g003.jpg
case_images: PMC8422535_01_JKCVHL-8-001-g003.jpg
case_images: F3
case_images: Histopathological examination revealed an infiltrative spindle cell tumour with haemangiopericytoma-like blood vessels with little intervening stroma arranged in fascicular and storiform patterns (Figure 3).
case_images: The immunohistochemistry of the tumour tissue. (A) The positive reaction to CD99. (B) The positive reaction to pan-CK. (CD) The positive reaction to TLE-1.
case_images: JKCVHL-8-001-g004.jpg
case_images: PMC8422535_01_JKCVHL-8-001-g004.jpg
case_images: F4
case_images: TLE-1 and BCL2, with scattered positivity for pan-CK, and negative for CD34, CD31, RCC, CD10, S100, EMA and SMA. This is consistent with the diagnosis of synovial sarcoma, monophasic type (Figure 4).