PMC3928353_01
The CT shows a 8x5.8x5.3 cm sized heterogeneous left renal mass without lymph node enlargement.
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F1
Abdominal computed tomography (CT) revealed a 6.8x5.8x5.3 cm sized left renal mass without lymph node enlargement (Fig. 1).
Histologic and immunostain appearance. Cut section of the kidney reveals a well circumscribed, ovoid, firm mass in the lower pole of the kidney (A). Histology showed the characteristic findings of rhabdoid tumor including a highly cellular neoplasm composed of tumor cells of varying size with prominent nucleoli and abundant cytoplasm (B, hematoxylin-eosin stain, x400). Immunostains showed negative staining for INI1 (C).
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F2
Gross examination revealed a well circumscribed, ovoid, firm mass in the lower pole of the kidney (Fig. 2A). Microscopic findings revealed that the tumor was a highly cellular neoplasm composed of tumor cells of varying size with prominent nucleoli and abundant cytoplasm (Fig. 2B). Immunohistochemistry showed loss of INI1 protein staining (Fig. 2C).
The T1-weighted enhancing lumbar MRI shows a 6.5x1 cm sized intradural extramedullary tubular mass with heterogeneous enhancement at L1-S1 level.
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F3
Brain magnetic resonance imaging (MRI) did not show evidence of metastatic disease, but lumbar MRI revealed a 6.5x1 cm sized intradural extramedullary tubular mass with heterogeneous enhancement at L1-S1 level (Fig. 3).
A : Intraoperative photography shows the tumor with pale yellowish color. B : Final photography after removal of the tumor shows nerve root.
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F4
Conus medullaris was displaced by the hypervascular tumor with yellowish color, however the upper margin of the tumor was clear (Fig. 4A). Near total removal of the tumor was performed using cavitron ultrasonic surgical aspirator, and there was no root injury during the surgery (Fig. 4B).
Histology of spinal surgical specimen shows small round cell tumor with extensive necrosis consistent with metastatic rhabdoid tumor (hematoxylin-eosin stain, x200).
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F5
The pathologic findings were consistent with metastatic malignant rhabdoid tumor (Fig. 5).