case_images: PMC3861592_01
case_images: Tumor localized on the upper pole of the left kidney that is (A) heterogeneous with a central lower density and (B) showing heterogeneous attenuation with peripheral enhancement and central irregular non-enhancement.
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case_images: PMC3861592_01_OL-07-01-0285-g00.jpg
case_images: f1-ol-07-01-0285
case_images: No invasion was identified of the ambient structures in the upper pole of the left kidney (Fig. 1A). Enhanced CT showed heterogeneous attenuation with peripheral enhancement and central irregular non-enhancement (Fig. 1B).
case_images: (A) Gross appearance and (B) histopathological examination of the resected specimen (hematoxylin and eosin; magnification, x100).
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case_images: PMC3861592_01_OL-07-01-0285-g01.jpg
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case_images: The gross appearance of the resected specimen of the giant mass showed a well-circumscribed, non-encapsulated, grayish-yellow solid tumor with areas of necrosis in black that measured ~20x13x10 cm3 (Fig. 2A). Histologically, the tumor was composed of spindle-shaped myoid cells with a concentric arrangement of cells around numerous variably-sized blood vessels, and the tumor cells were arranged in nests or fascicles (Fig. 2B).
case_images: Immunohistochemically, the tumor cells were diffusely positive for (A) smooth muscle actin and (B) CD10, and (C) had a Ki-67 index of <1%, but were negative for (D) S-100 (magnification, x100).
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case_images: PMC3861592_01_OL-07-01-0285-g02.jpg
case_images: f3-ol-07-01-0285
case_images: Immunohistochemically, the tumor cells were diffusely positive for smooth muscle actin (Fig. 3A), cluster of differentiation (CD)10 (Fig. 3B) and had a Ki-67 index of <1% (Fig. 3C). However, staining was negative for CD34, desmin, S-100 protein (Fig. 3D), cytokeratin, human melanoma black (HMB)-45, B-cell lymphoma (Bcl)-2 and CD99.