PMC4719796_01
Large 12 cm x 10 cm enhancing left renal mass with central necrosis and calcification on initial presentation (black arrow).
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A 49-year-old female who presented to our institution with vague abdominal pain, nausea, and a 15 lbs weight loss was found to have a 19 x 12 x 10 cm left enhancing renal mass with central necrosis and calcifications on abdominal CT scan (Fig. 1).
Eight years post left radical nephrectomy with new 4.3 cm enhancing right renal mass with necrotic foci (black arrow).
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Eight years after the initial operation, a follow up CT scan revealed a 4.3 cm exophytic, low complexity, enhancing solid mass with cystic and necrotic foci occupying the lower pole of the right kidney highly suspicious for malignancy (Fig. 2).
Histopathology of the resected metachronous right kidney lesion revealing spindle cell architecture, cytological atypia, and diffuse CD 99 staining on immunohistochemistry consistent with malignant SFT.
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Immunohistochemistry revealed that tumor cells were positive for CD34 (~10%), diffuse CD99 (Fig. 3), diffuse BCL-2 and vimentin.