| 摘要 |
Retroperitoneal undifferentiated sarcoma is a soft tissue sarcoma that is highly positive
for vimentin but has no reactions to various cell-specific markers in immunohistochemical
study. This tumor has never been reported in a hemodialysis patient with
chronically immunosuppressed uremic state. We report a case of retroperitoneal
undifferentiated sarcoma in a 50-year-old uremic man who presented with intermittent
left flank dull pain and painless hematuria. MRI revealed a huge left
perirenal mass, and complete resection was achieved. The pathological examination
of the tumor cells revealed poorly-differentiated spindle or oval-shaped sarcoma cells,
and the immunohistochemical study excluded the diagnosis of rhabdomyosarcoma,
leimyosarcoma, liposarcoma, angiomyolipoma, sarcomatoid renal cell carcinoma, and
sarcomatoid transitional cell carcinoma. This indicated that the sarcoma did not show
any differentiation. The patient had an uneventful postoperative course and is currently
well 3 years after operation. We review the clinical picture of this tumor in a
hemodialysis patient, elucidate the undifferentiated histopathological characteristics
by immunohistochemical study and point out the possible connection between
sarcoma formation and immunosuppressive status from uremia. |
