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Carcinosarcoma of the Kidney

߾ 1969 17 6ȣ p.485 ~ 488
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Carcinosarcoma is a rare malignant neoplasm consisting of both epithelial and non-epithelial components, that is, carcinoma and sarcoma, in the same tumor. It is most common in the uterus and has also been found in the lung, esophagus, thyroid gland, stomach, and so forth.
However, carcinosarcoma of the kidney has been considered to be very rare. The patient was 52 year-old housewife and complained slow growing palpable mass at right lower quadrant accompanies by hematuria without subjective symptoms, such as pain, for six months duration.. Except for palpable mass at right lower quadrant physical examination was negative. Laboratory examination disclosed hemoglobin 7.4 gm per 100m1., hematocrit 27 percent and white blood cells count 10,200 per cu. mm. Urinalyses disclosed 10 to 20 erythrocytes per high power field. An intravenous pyelogram revealed large tumor mass with complete. filling defect of the right kidney. Grossly,-the removed kidney measured 16 X 12.5 X 8cm, and weighed 700gm. The, renal parenchyma was completely replaced by an oval shaped tumor mass without encapsulation. The tumor revealed yellowish-red in color and soft friable consistency with focal calcifications on the cut surface. The histopathology of the lesion revealed a malignant neoplasm comprised of both epithelial and. mesenchymal elements. The former was characterized by clusters and large groups of polygonal cells with clear cytoplasm. Nuclei were large, pleomorphic and intensely hyperchromatic. Mitoses were frequent. In some areas, there were hemorrhagic necrosis and calcifications. The mesenchymal portion of the tumor was comprised of spindle shaped phleomorphic cells with occasionally mitoses. A brief review of literature was made.