Spontaneous Rupture of a Renal Angiosarcoma

Abstract

Here we describe the clinical, radiologic, histopathological and immunohistochemical features of a rare spontaneous rupture of renal angiosarcoma detected in the left kidney of a 55-year-old male. Due to the rarity of this neoplasm (less than 15 cases have been reported), there is no unanimous concensus for therapy following radical nephrectomy. In our case there was no flank trauma and retroperitoneal haematoma around the left kidney was seen on computed tomography. The patient underwent left radical nephrectomy and died about 3 months after operation due to multiple bone and liver metastases. To our knowledge, this is the first report of spontaneous rupture of renal angiosarcoma and we suggest that it should be borne in mind that renal angiosarcoma may be a cause of retroperitoneal haematomas.

Pediatric and adult primary sarcomas of the kidney: a cross-sectional imaging review

“…Extra-renal AGSs are known to be associated with exposure to vinyl chloride, Thorotrast and radiation; these risk factors have not been described with primary renal AGSs. Common symptoms include flank pain and hematuria; AGSs may also manifest as large kidney masses that may rupture spontaneously (42). Histologically, the tumor cells form closely packed sinusoidal vascular channels lined by polygonal or spindleshaped tumor cells.…”

Imaging findings of ruptured abdominal and pelvic tumors

“…Very rare cases of ruptured multilocular cystic nephroma and renal angiosarcoma have been reported in the literature (44,45). However, the imaging findings are non-specific and include a cystic mass containing a hemorrhagic component and a perirenal hematoma, respectively.…”

Clinical and Pathologic Features of Primary Angiosarcoma of the Kidney

“…Other clinical features include haematuria, abdominal mass, weight loss, fatigue, dizziness, fever and malaise [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Rarely, patients may present with spontaneous rupture of the tumour resulting in retroperitoneal hematoma [11]. Renal angiosarcoma may co-exist with other tumours including minute clear cell carcinomas [14] and adult Wilms tumour [21].…”

“…The malignant endothelial cells exhibit multilayering and papillary tufting. Tumours may show foci of coagulative necrosis, extensive haemorrhage and significant mitotic activity [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]19]. A diffusely infiltrative growth pattern with variable invasion of perinephric fat and perirenal soft tissue may be confirmed on histology [1,4,19].…”