case_images: PMC11150575_01
case_images: (A) CT shows severe hydronephrosis of the right kidney. (B) Shows the gross appearance of the right kidney, the size was about 20cm x 15cm. (C) The tumor cells were disorganized and showed sarcomatoid changes with marked heterogeneity. (D) Tumor cells are spindle-shaped with ossification formation.
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case_images: PMC11150575_01_fonc-14-1361250-g001.jpg
case_images: f1
case_images: Figure 1A ). Consequently, the provisional diagnosis was severe right renal hydronephrosis, attributed to right ureteral stricture. Following the exclusion of surgical contraindications, an open right nephrectomy was conducted. Intraoperatively, exposure of the renal fascia revealed a significantly enlarged right kidney with thin cyst walls measuring approximately 20cm*15cm ( Figure 1B ), from which 1000 ml of pale yellow turbid fluid was drained. Pathological examination of the excised tumor revealed histological features indicative of a spindle cell tumor, including neutrophil infiltration in the right kidney ( Figures 1C, D ).
case_images: Immunohistochemical staining of the SRCC. (A) showed the spindle tumor cells were cytoplasmic positive for CD5/6. (B) showed the spindle tumor cells were cytoplasmic positive for CD10. (C) showed the spindle tumor cells were cytoplasmic positive for CD99. (D) showed the spindle tumor cells were cytoplasmic positive for CK. (E) showed the spindle tumor cells were cytoplasmic positive for Vinentin. (F) showed the spindle tumor cells were nuclear positive for PAX-8.
case_images: fonc-14-1361250-g002.jpg
case_images: PMC11150575_01_fonc-14-1361250-g002.jpg
case_images: f2
case_images: Bcl-2, ETV6, S100, Desmin, and PAS ( Figure 2 ). Based on the comprehensive pathology and immunohistochemistry findings, the diagnosis was confirmed as sarcomatoid renal cell carcinoma with local ossification and vascular invasion.