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Open Access Case Report

De novo malignant solitary fibrous tumor of the kidney

Tsan-Yu Hsieh14, Yi-Che ChangChien14, Wen-Hsiang Chen24, Siu-Chung Chen34, Liang-Che Chang14, Cheng-Cheng Hwang14, Hui-Ping Chein14 and Jim-Ray Chen14*

Author Affiliations

1 Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan

2 Department of Urology, Chang Gung Memorial Hospital, Keelung, Taiwan

3 Department of Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan

4 College of Medicine, Chang Gung University, Tao-yuan, Taiwan

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Diagnostic Pathology 2011, 6:96  doi:10.1186/1746-1596-6-96

Published: 5 October 2011

Abstract

The kidney is a relatively infrequent site for solitary fibrous tumor (SFT). Among the previously reported cases, only two cases of malignant renal SFT developing via dedifferentiation from a pre-existing benign SFT have been reported. Here we reported a case of de novo malignant renal SFT clinically diagnosed as renal cell carcinoma in a 50-year-old woman. The tumor was circumscribed but unencapsulated and showed obvious hemorrhagic necrosis. Microscopically, the tumor was composed of patternless sheets of alternating hypercellular and hypocellular areas of spindle cells displaying mild to moderate nuclear atypia, frequent mitoses up to 8 per 10 high power fields, and a 20% Ki-67 proliferative index. Immunohistochemical studies revealed reactivity for CD34, CD99 and vimentin, with no staining for all other markers, confirming the diagnosis of SFT. No areas of dedifferentiation were seen after extensive sampling. Based on the pathologic and immunohistochemical features, a diagnosis of de novo malignant renal SFT was warranted. Our report expands the spectrum of malignant progression in renal SFTs. Even though this patient has been disease-free for 30 months, long-term follow-up is still mandatory.

Keywords:
solitary fibrous tumor; kidney; malignant; de novo; dedifferentiation; CD34