Case 1
Upper GI Slide Seminar
by Dr. R. Swamy
Kidwai, Bangalore
February 2008
Case 10
HISTORY:
Right nephrectomy in April 2006 for a renal cell carcinoma. The surgical specimen showed a conventional renal cell carcinoma with sarcomatoid change. It was found that he had widespread disseminated disease and he was enrolled for Sunitinib(anti-tyrosine kinase) trial study for advanced renal cell carcinoma. He developed a pedunculated polyp over the lesser curvature of the stomach in April 2007. A snare sample of the polyp was submitted for histology which was inconclusive.
Meanwhile, the patient died with an inconclusive diagnosis of his gastric pathology. A limited hospital postmortem (confined to the stomach bed) was performed to establish the diagnosis. At autopsy, there was widespread tumour dissemination within the stomach wall extending into the superficial abdominal wall and the lesser sac structures.
Digital images from the renal cell carcinoma, snare sample of gastric polyp and autopsy material.
Results of other immunos in the sarcomatoid component :
Vimentin +
EMA -
CD10 -
RCC antigen -
