Management of renal extraskeletal mesenchymal chondrosarcoma

BMC Surgery

Ioan Coman¹  Alexandru Irimie²  Bogdan Feciche⁴  Victor-Dan Ona⁶  Nicolae Crisan⁶  Catalina Bungardean⁵  Ciprian Tomuleasa³  Vitalie Gherman⁶ 

[1] Department of Urology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania;Department of Surgery, Ion Chiricuta Comprehensive Cancer Center, Cluj Napoca, Romania;Department of Hematology, Ion Chiricuta Cancer Center, Cluj Napoca, Romania;Department of Urological Surgery, County Emergency Hospital in Satu-Mare, Cluj Napoca, Romania;Department of Pathology, Clinical Municipal Hospital in Cluj Napoca, Cluj Napoca, Romania;Department of Urological and Robotic Surgery, Clinical Municipal Hospital in Cluj Napoca, Cluj Napoca, Romania

关键词: Case report;    Renal surgical management;    Extraosseous mesenchymal chondrosarcoma;   

Others  :  1090855
DOI  :  10.1186/1471-2482-14-107

 received in 2013-10-21, accepted in 2014-11-27,  发布年份 2014

【 摘 要 】

Background

Primary mesenchymal chondrosarcoma of the kidney is an extremely rare malignant tumor. To our best knowledge, only 9 such cases have been reported so far.

Case presentation

In the current paper, we present the case of a 67 year-old patient with recurrent left lumbar pain, increased fatigability and intermittent macroscopic hematuria. He underwent a surgical resection of the left kidney and left hemicolon.

The pathological diagnosis was primary extraskeletal renal mesenchymal chondrosarcoma. Overall survival was 9 months, with pulmonary metastasis and local recurrence at 6 months. The management of the patient is described, from the initial differential diagnosis, after the first clinical examination to the surgical resection, with a special emphasis on the surgical procedures that were carried out.

Conclusion

Extraskeletal chondrosarcoma of primary origin in the kidney are extremely rare tumors with a highly malignant potential and very poor prognosis. Because the role of chemotherapy or radiation therapy has not been evaluated properly yet, we underline the importance of surgery in the management of such cases as the main and best approach to achieve clinical remission and long-term survival, provided the patient is referred to a surgical consult in time.

【 授权许可】

   
2014 Gherman et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]Lichtenstein L, Bernstein D: Unusual benign and malignant chondroid tumors of bone. A survey of some mesenchymal cartilage tumors and malignant chondroblastic tumors, including a few multicentric ones, as well as many atypical benign chondroblastomas and chondromyxoid fibromas. Cancer 1959, 12:1142-1157.
• [2]Dahlin DC, Henderson ED: Mesenchymal chondrosarcoma. Further observations on a new entity. Cancer 1962, 15:410-417.
• [3]Meijer D, de Jong D, Pansuriya TC, van den Akker BE, Picci P, Szuhai K, Bovee JV: Genetic characterization of mesenchymal, clear cell, and dedifferentiated chondrosarcoma. Genes Chromosomes Cancer 2012, 51(10):899-909.
• [4]Chen Y, Wang X, Guo L, Li Y, Deng S, Liu Y, Guo L: Radiological features and pathology of extraskeletal mesenchymal chondrosarcoma. Clin Imaging 2012, 36(4):365-370.
• [5]Nakashima Y, Unni KK, Shives TC, Swee RG, Dahlin DC: Mesenchymal chondrosarcoma of bone and soft tissue. a review of 111 cases. Cancer 1986, 57(12):2444-2453.
• [6]Seo CY, Jung ST, Byun JW: Extraskeletal mesenchymal chondrosarcoma in the axillary region: reports of two cases. Korean J Pathol 2012, 46(5):483-488.
• [7]Hsing CT, Oh SY, Lee S, Kwon HC, Kim SH, Park TH, Woo JS, Na SH, Kim HJ: Extraskeletal mesenchymal chondrosarcoma of the heart responded to systemic chemotherapy: a case report. Cancer Res Treat 2007, 39(3):131-133.
• [8]Abbas M, Ajrawi T, Tungekar MF: Mesenchymal chondrosarcoma of the thyroid - a rare tumour at an unusual site. APMIS 2004, 112(6):384-389.
• [9]Bu X, Dai X: Primary mesenchymal chondrosarcoma of the pancreas. Ann R Coll Surg Engl 2010, 92(3):W10-W12.
• [10]Odashiro A, Leite LV, Oliveira RS, Tamashiro C, Pereira PR, Miiji LN, Odashiro DN, Burnier MN Jr: Primary orbital mesenchymal chondrosarcoma: a case report and literature review. Int Ophthalmol 2009, 29(3):173-177.
• [11]Kaneko T, Suzuki Y, Takata R, Takata K, Sakuma T, Fujioka T: Extraskeletal mesenchymal chondrosarcoma of the kidney. Int J Urol 2006, 13(3):285-286.
• [12]Malhotra CM, Doolittle CH, Rodil JV, Vezeridis MP: Mesenchymal chondrosarcoma of the kidney. Cancer 1984, 54(11):2495-2499.
• [13]Karanauskas S, Wells RG, Sty J: Extraosseus uptake with bone scintigraphy. renal mesenchymal chondrosarcoma with metastasis. Clin Nucl Med 1991, 16(5):375-377.
• [14]Kim GE, Kim DK, Park IJ, Ro JY: Mesenchymal chondrosarcoma originating from the femoral vein. J Vasc Surg 2003, 37(1):202-205.
• [15]Rockelein G, Sebeikat D, Hecken-Emmel M: Primäres Chondrosarkom des Ureters. Dtsch Med Wochenschr 1990, 115(49):1868-1871.
• [16]Kransdorf MJ, Meis JM: From the archives of the AFIP. extraskeletal osseous and cartilaginous tumors of the extremities. Radiographics 1993, 13(4):853-884.
• [17]Buse S, Behnisch W, Kulozik A, Autschbach F, Hohenfellner M: Primary chondrosarcoma of the kidney: case report and review of the literature. Urol Int 2009, 83(1):116-118. doi:10.1159/000224880
• [18]Volpe A, Kachura JR, Geddie WR, Evans AJ, Gharajeh A, Saravanan A, Jewett MA: Techniques, safety and accuracy of sampling of renal tumors by fine needle aspiration and corebiopsy. J Urol 2007, 178(2):379-386.
• [19]Ljungberg B, Cowan NC, Hanbury DC, Hora M, Kuczyk MA, Merseburger AS, Patard J-J, Mulders PFA, Sinescu IC: EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol 2010, 58(3):398-406.
• [20]Department of Health: The ionizing radiation (medical exposure) regulations 2000. London: DOH; 2000.
• [21]Bertoni F, Picci P, Bacchini P, Capanna R, Innao V, Bacci G, Campanacci M: Mesenchymal chondrosarcoma of bone and soft tissues. Cancer 1983, 52(3):533-541.
• [22]Sato N, Minase T, Yoshida Y, Narimatsu E, Muroya K, Asaishi K, Kikuchi K: An ultrastructural study of extraskeletal mesenchymal chondrosarcoma. Acta Pathol Jpn 1984, 34(6):1355-1363.
• [23]Huvos AG, Rosen G, Dabska M, Marcove RC: Mesenchymal chondrosarcoma. A clinicopathologic analysis of 35 patients with emphasis on treatment. Cancer 1983, 51(7):1230-1237.
• [24]Knott PD, Gannon FH, Thompson LD: Mesenchymal chondrosarcoma of the sinonasal tract: a clinicopathological study of 13 cases with a review of the literature. Laryngoscope 2003, 113(5):783-790.
• [25]Rushing EJ, Armonda RA, Ansari Q, Mena H: Mesenchymal chondrosarcoma: a clinicopathologic and flow cytometric study of 13 cases presenting in the central nervous system. Cancer 1996, 77(9):1884-1891.
• [26]Dantonello TM, Int-Veen C, Schuck A, Furtwaengler R, Claviez A, Schneider DT, Klingebiel T, Bielack SS, Koscielniak E, CWS Study Group: Mesenchymal chondrosarcoma of soft tissues and bone in children, adolescents, and young adults: experiences of the CWS and COSS study groups. Cancer 2008, 112(11):2424-2431.
• [27]Jagelman DG, Turnbull RB Jr: Colectomy for malignant disease of the colon: the 'no-touch' isolation technique. In Operative Surgery Fundamental Techniques: Colon, Rectum und Anus. Edited by Todd IP. London, Boston: Butterworths; 1977:106-117.
• [28]Sugarbaker PH: Successful management of microscopic residual disease in large bowel cancer. Cancer Chemother Pharmacol 1999, 43(Suppl):S15-S25.