engleski

Renal hemangiopericytoma:a case report

Haemangiopericytoma is rare, controversial entity and in soft tissue, most lesions are actually solitary fibrous tumors, monophasic synovial sarcomas or myofibromatoses. It is historically defined as lesion with thin walled, branching vascular pattern, although this pattern is common in many lesions. It is not a lesion of pericytes, except at sinonasal location and is most common in deep soft tissue, particularly pelvic retroperitoneum. In most cases it has benign behavior but metastases are well documented, particularly in large tumors with necrosis, high mitotic activity and nuclear pleomorphism. About 30 primary renal haemangiopericytomas are reported in the literature. Most of them arise in the renal sinus and the perirenal tissue. There are no specific radiological features. We present a case of primary renal haemangioperycitoma in a 65 year- old male patient. Patient was without any previous medical history and his masseur felt lump in the right lumbal area. Urology examination and CT scan showed renal tumor measuring up to 23 cm. Nephrectomy with ureterectomy was performed. Macroscopic examination revealed tumor measuring 23x17x11.5 cm, well circumscribed, seamed incapsulated, gray in color, with large areas of necrosis and hemorrhage. It seemed it is placed against renal parenchyma. Thin walled, branching vessels were found but also areas with epitheloid and spindle cells with relative nuclear pleomorphism and prominent nucleoli, also some cystic spaces. Focally mitotic figures were frequent in some areas and proliferative index was up to 40% (Ki-67). Immunohistochemicaly neoplastic cells showed strong positivity for vimentin, CD10 and focally also for C34 and cytokeratin-PAN. Case was also sent on consultation for second opinion. It was resolved as haemangiopericytoma with malignant features. Patient didn’t received any oncological therapy and after 5 month is well and without any residual or metastatic tumor.

kidney; hemangiopericytoma

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