Ewing’s Sarcoma of the Kidney Complicated by a Wunderlich Syndrome

Manescu, Mihai Razvan; A, Sahyoun; Froment, Nicolas; Crişan, Nicolae; Girot, Vincent

doi:10.1155/2015/601038

Cited by 2 publications

(3 citation statements)

References 7 publications

(9 reference statements)

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“…Areas of high density correspond to areas of internal haemorrhage, and areas of low density correspond to areas of necrosis. The CT findings of the patient whose case is presented here are consistent with those previously reported [16][17][18][19][20][21][22][23]. As a radiation-free, inexpensive, and convenient examination method, US can be the primary choice in the diagnosis of EWS/pPNETs.…”

Section: Case Presentationsupporting

confidence: 88%

“… Imaging methods, such as CT and MRI, have their own specific indications [ 14 ] to can help make a correct diagnosis [ 15 ]. The EWS/pPNET of the kidney was an inhomogeneous mass with unobvious renal vessels, no signs of invasion, and no calcifications on CT [ 16 , 17 ]. In a 60-year-old patient with an EWS/pPNET of the kidney, ultrasound revealed an exophytic cortical cyst of the left kidney with irregular echogenic septa.…”

Section: Discussionmentioning

confidence: 99%

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Extraosseous Ewing's sarcoma/peripheral primitive neuroectodermal tumour of the kidney: a case report and literature review

Nie

2022

BMC Urol

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Background Extraosseous Ewing's sarcoma/peripheral primitive neuroectodermal tumours(EWS/pPNETs) of the kidney are rare. Signs and symptoms are atypical in EWS patients. Presenting symptoms include haematuria, abdominal pain, or a palpable mass. A comprehensive review of the literature shows that it is difficult to make an accurate diagnosis based on physical examination alone. The imaging findings of EWS/pPNETs are nonspecific. We used contrast-enhanced ultrasound (CEUS) to diagnose an EWS/pPNET in our patient, which had never been reported previously to our knowledge. Case presentation This article reports the case of a 20-year-old female with an abdominal mass and gross haematuria for 1 month. The ultrasound revealed a hypoechoic mass with a clear margin at the lower pole in the left kidney. CEUS demonstrated signs of annular enhancement and heterogeneous enhancement of the tumour, and simultaneous wash-in was predominant. Computed tomography images showed an elliptical low-density tumour. The patient underwent a left kidney resection, and the pathological diagnosis was an EWS/pPNET. Twenty-one days after the kidney operation, the patient underwent 8 cycles of a CAV (vinorelbine, ifosfamide, epirubicin) + IE (isocyclophosphamide, etoposide) chemotherapy regimen. Subsequently, radiotherapy (dose: 45 Gy, radiation field:the tumour bed following surgical resection) was administered for nearly 30 days. The patient had no signs of local recurrence or metastasis within a follow-up of 4 years. Conclusions As a radiation-free, inexpensive, convenient, and repeatable examination method, ultrasound was the primary choice for kidney examination. Early CEUS was helpful to make an accurate diagnosis. Surgery and adjuvant radiation or chemotherapy administered in a timely manner can prevent further deterioration.

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Section: Case Presentationsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Extraosseous Ewing's sarcoma/peripheral primitive neuroectodermal tumour of the kidney: a case report and literature review

Nie

2022

BMC Urol

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“…CT scan of the abdomen is the preferred initial imaging modality, with 100% sensitivity, because it can be used to see the cause of bleeding, simultaneously ruling out other causes. 13,14 However, other cross-sectional imaging tools, Undifferentiated Renal Cell Carcinoma Presenting As Wunderlich Syndrome: A Case Report Georgetown Medical Review such as ultrasonography and MRI, can also be considered. 4 MRI can be considered when the initial CT imaging does not identify the source of bleeding, while ultrasonography is a highly sensitive modality to detect perinephric hematoma.…”

Section: Clinical Discussionmentioning

confidence: 99%

Undifferentiated Renal Cell Carcinoma Presenting As Wunderlich Syndrome: A Case Report

Karki,

Toofantabrizi

2023

Georgetown Medical Review

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Wunderlich syndrome is a spontaneous, non-traumatic, sub-capsular perinephric hematoma described by a triad of acute flank pain, the presence of flank mass, and hypovolemic shock. This acute syndrome is mostly caused by renal malignancies, particularly renal angiomyolipoma and renal cell carcinoma. Computed tomography (CT) scan is the preferred diagnostic modality for Wunderlich syndrome and its treatment depends on the cause. Herein, we present a 41- year-old male admitted with flank pain, who was subsequently found to have thrombocytosis, hematuria, and hypotension. A computed tomographic scan revealed a kidney mass and hematoma, which was removed. Biopsy of the mass revealed undifferentiated renal cell carcinoma and the mass caused malignant pleural effusion. This case report demonstrates increasing platelet counts, which raised concern for advanced malignancy and the triad of features may not always be present. It also highlights the etiology, clinical manifestation, and management of this syndrome.

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Ewing’s Sarcoma of the Kidney Complicated by a Wunderlich Syndrome

Cited by 2 publications

References 7 publications

Extraosseous Ewing's sarcoma/peripheral primitive neuroectodermal tumour of the kidney: a case report and literature review

Extraosseous Ewing's sarcoma/peripheral primitive neuroectodermal tumour of the kidney: a case report and literature review

Undifferentiated Renal Cell Carcinoma Presenting As Wunderlich Syndrome: A Case Report

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