Malignant Giant Cell Tumor of the Kidney

Fatima N. Obeidat, Saleh N. Najjar, Bashar N. Al-Zghoul

Abstract


Many benign and malignant tumors arise in the adult kidney. Of malignant tumors, the most common is renal cell carcinoma which accounts for 3% of adult malignancies. Other less common tumors can affect the kidney such as small cell carcinoma, carcinoid tumor, mixed epithelial stromal tumor and a variety of mesenchymal tumors.
A rare tumor arises in the adult kidney is malignant giant cell tumor of the kidney or what so called giant cell carcinoma of the kidney. Up to our knowledge only two cases were reported so far in the literature. The cell of origin of this tumor is believed to be from the mesenchymal cell of mononuclear phagocyte cell line, although others suggested an epithelial origin. Microscopically, this tumor resemble giant cell tumor of the bone, composed of mononuclear cells with high mitotic activity admixed with numerous osteoclast-like giant cells.
We report a case of an 80 year old female patient who presented with loin pain and hematuria. Radiological examination showed a large tumor occupying the upper pole of the kidney. The patient underwent radical nephrectomy. Microscopic examination showed a malignant tumor with large areas of coagulative tumor necrosis and proliferation of mononuclear cells with high mitotic activity, interspersed in between were many osteoclast-like multinucleated giant cells. One focus showed osseous metaplasia. The tumor extended to the perinephric fat. The overall picture was consistent with malignant giant cell tumor of the kidney.
This case is considered the third case in the literature and we report it because of its extreme rarity

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