Open Access

Epithelioid angiosarcoma arising in schwannoma of the kidney: report of the first case and review of the literature

  • G. Iannaci1Email author,
  • M. Crispino2,
  • P. Cifarelli2,
  • M. Montella3,
  • I. Panarese3,
  • A. Ronchi3,
  • R. Russo3,
  • G. Tremiterra3,
  • R. Luise3 and
  • P. Sapere1
World Journal of Surgical Oncology201614:29

https://doi.org/10.1186/s12957-016-0789-5

Received: 5 June 2015

Accepted: 26 January 2016

Published: 3 February 2016

Abstract

Background

Schwannoma and angiosarcoma are infrequent pathologies that have been rarely reported in the kidney. Angiosarcoma is an uncommon malignant tumor presenting a recognizable vascular differentiation. It can develop in any site but the most common locations include the skin, soft tissues, breast, bone, liver, and spleen while renal localization has been very rarely reported in the literature. Schwannoma is a benign peripheral nerve sheath tumor composed of cells with the immunophenotype and ultrastructural features of differentiated Schwann cells. It has a wide anatomical distribution but the most frequent locations include subcutaneous tissues of the extremities and the head and neck region and the retroperitoneal and mediastinal soft tissues. The occurrence of an angiosarcoma in a pre-existing schwannoma is an extremely rare event with <20 cases reported in worldwide literature. In the present study, a renal case of angiosarcoma arising in schwannoma is presented with a detailed review of the pertinent literature.

Case Presentation

A 56-year-old man was admitted with a few days history of lower back pain and hematuria. Abdominal ultrasound showed a mass inside the left renal medulla. Subsequent imaging investigations with computed tomography and magnetic resonance confirmed the presence of the lesion and showed a pulmonary metastasis.

Conclusions

The final histopathological examination led to the diagnosis of epithelioid angiosarcoma arising in a schwannoma. The patient came to death a few months later due to a massive hemothorax. To the best of our knowledge, the present is the first case of an angiosarcoma arising in a schwannoma of the kidney.

Keywords

Kidney angiosarcomaEpithelioid angiosarcomaKidney schwannomaAngiosarcoma arising in schwannomaLiterature review

Background

Schwannoma (also known as neurilemmoma) is a benign peripheral nerve sheath tumor composed of cells with the immunophenotype and ultrastructural features of differentiated Schwann cells. It occurs in patients of any age with a slight predilection for adults [1]. The anatomic distribution is wide but the most frequent locations include subcutaneous tissues of the extremities and the head and neck region and the retroperitoneal and mediastinal soft tissues [1]. In most cases, it presents itself as a sporadic solitary lesion, but some cases are associated with the hereditary syndrome neurofibromatosis type 2 [2]. The etiology of schwannoma seems to be linked to loss of expression of the protein merlin that performs a number of critical functions such as contact-dependent inhibition of proliferation, cellular adhesion, and transmembrane signaling [3]. Diagnosis may be suspected on the basis of the clinical features of the lesion and the possible relationship with a nerve but it always requires pathological investigation. The gross appearance is that of a nodular, well-circumscribed, and encapsulated mass with a pink to yellow cut surface. Histologically, the tumor is composed of spindle cells with indistinct cell borders and moderately abundant eosinophilic cytoplasm. The most characteristic histologic feature is the nuclear palisading and the presence of eosinophilic masses circumscribed by rows of nuclei formerly known as Verocay bodies. There are two tissue types: Antoni A (hypercellular) and Antoni B (hypocellular with relatively abundant loose tissue). Many distinct variants of schwannoma have been described: ancient, plexiform, cellular, melanotic, microcystic, and epithelioid. By immunohistochemistry, tumor cells express S100, vimentin, calretinin, basal lamina components, and calcineurin. Schwannoma very rarely recurs after complete surgical excision, that is almost always curative, and malignant transformation is extremely rare [1]. All cases of malignant transformation reported in literature have occurred in sporadic schwannoma, and the great majority of cases consisted of a malignant peripheral nerve sheath tumor [4]. No case has been reported in patients with neurofibromatosis. The most common symptoms observed in patients with malignant change in schwannoma included pain or rapid enlargement of a pre-existing lesion. These symptoms are rare in schwannoma and should therefore support the suspicion of a malignant transformation. Sarcomas generally do not arise in peripheral nerve sheath tumors, with the exception of angiosarcoma [5]. The majority of malignant peripheral nerve sheath tumors and all the cases of angiosarcoma arising in a schwannoma have an epithelioid morphology [6]. Up to date, there is no explanation for this finding.

Angiosarcoma is an uncommon malignant tumor presenting a recognizable vascular differentiation. It accounts for only 2 to 4 % of soft tissue sarcomas [7] and occurs mainly in the adulthood and elderly, but occasional cases in children have been reported [8]. It can develop in any site but the most common locations include the skin, soft tissues, breast, bone, liver, and spleen, while the rare cases seen in children occur especially in mediastinum including the heart and pericardium. Known risk factors include previous radiation therapy and traumas, but the etiology of this neoplasm remains unknown. Recent studies have shown the role of genes involved in the receptor protein tyrosine kinase pathway, in particular the upregulation of MYC, KIT, and RET and downregulation of CDKN2C in post-radiation angiosarcomas [9]. Clinically, the symptomatology depends substantially on the location of the lesion and is related to the effect of the mass that can compress adjacent anatomical structures, to the anemia resulting from blood loss and to lymphedema; other symptoms often observed include pain, weight loss, and asthenia. The gross appearance is characterized by extensive hemorrhagic areas and infiltrating margins. Epithelioid morphology is rare in cutaneous angiosarcomas while it is frequently seen in those arising in soft tissues and visceral locations. Regardless of the histological features, angiosarcoma is considered high grade by definition [10]; the prognosis is very poor; soft tissue forms present more than 50 % of mortality within 1 year of diagnosis [11] because of the strong tendency for recurrence and the almost constant occurrence of disseminated metastases. At older ages, larger tumor size and retroperitoneal location are poor prognostic factors.

We describe a case of a complex renal lesion that consists of two components changing abruptly within the tumor: a larger, malignant neoplasm diagnosed as an epithelioid angiosarcoma and a minor benign neural tumor diagnosed as schwannoma. It is well known that angiosarcomas can develop in neurofibromas and malignant peripheral nerve sheath tumors, especially in patients with von Recklinghausen’s disease. The occurrence of an angiosarcoma in a schwannoma is a very rare event as only 14 cases have been reported in the literature. To our knowledge, the present is the first case of an angiosarcoma arising in a schwannoma of the kidney.

Case presentation

A 56-year-old man with a history of non-insulin dependent diabetes mellitus was referred to the surgical department because of the onset of lower back pain and hematuria that occurred the previous day. The patient was not a smoker and denied alcohol consumption; his family history was unremarkable and there was no other complaint. The ultrasound of the left kidney revealed the presence of stones in the renal pelvis causing obstruction of the ureteral meatus and consequent dilatation of the upper calix. During the examination, the presence of a solid neoplasm was noticed that involved the renal medulla reaching the hilum area without signs of hilar infiltration. For further investigations, the patient underwent CT (computed tomography) and MR (magnetic resonance) that showed the slight enhancement and extensive necrotic areas of the lesion and the existence of a solid nodule with same features in the left lung, likely due to metastases (Figs. 1a-1b). A lombotomic total nephrectomy was performed, and the patient had an uneventful post-operative recovery.
Fig. 1

a Computed tomography: imaging identifies an intraparenchymal nodule in the left lung. b Computed tomography: imaging identifies the presence of a nodular mesonephric hypodense lesion characterized by post contrastographic enhancement. c Gross imaging: the kidney shows an irregular profile with granulating appearance of the hilum. (d) Gross imaging: sectioned tumor appears hemorrhagic, soft, and reddish

Grossly, the kidney presented irregular profile due to a hilar lesion measuring 4 cm × 2.5 cm. On cut sections, it was highly hemorrhagic, soft, and reddish with infiltrating borders (Figs. 1c-1d). The tumor was extensively sampled. Microscopic examination was performed on paraffin-embedded sections stained with hematoxylin and eosin (Figs. 2 and 3). Histopathological examination showed a proliferation of canalicular structures of various sizes, sometimes with some degree of cystic changes, lined by atypical cells with epithelioid features, deeply invading the renal parenchyma and the perinephric fat. Many of these structures contained red blood cells giving the idea that it was a vascular lesion. In some fields was observed an almost solid growth pattern with erythrocytes trapped in thin spaces between neoplastic cells. Marked cellular pleomorphism, enlarged and hyperchromic nuclei, irregular nuclear contour, prominent nucleoli, and frequent mitotic figures were also evident. In the context of this lesion, few fields showed a quite different morphology consisting of spindle cells arranged in palisading fashion without cellular atypia or invasive features. An immunohistochemical study was performed on formalin-fixed paraffin-embedded tissue block to define the histogenesis of the lesion. Pre-diluted antibodies produced by Ventana-Roche were used, directed against pan-cytokeratin (clone AE1/AE3/PCK26; mouse monoclonal), CD34 (clone QBEnd/10; mouse monoclonal), factor VIII (rabbit polyclonal), Ki67 (clone 30-9; mouse monoclonal), S100 (clone 4C4.9; mouse monoclonal), EMA (clone E29; mouse monoclonal), and CD10 (clone SP67; rabbit monoclonal). The malignant population was reactive for pan-cytokeratin, CD34, factor VIII, partially positive for Ki67 (positivity in about 40 % of neoplastic cells) and negative for S100, EMA and CD10, therefore was consistent with epithelioid angiosarcoma. Otherwise, the benign spindle cells population was positive for S100 and negative for Ki67 and epithelial and endothelial markers. It was so interpreted as residuals of pre-existent schwannoma. In view of these morphological and immunohistochemical findings, a diagnosis of primary renal epithelioid angiosarcoma probably arising in schwannoma was made. A CT-guided fine-needle aspiration cytology of the pulmonary lesion was subsequently performed that showed CD31-positive atypical epithelioid cells in the context of numerous erythrocytes, confirming the diagnosis of lung metastasis of angiosarcoma. During the post-operative period, the patient has not been subjected to antineoplastic therapy because of poor general health and he came to exitus a few months after diagnosis, because of a massive hemothorax caused by lung metastasis.
Fig. 2

a H&E staining (×10): numerous neoplastic vascular channels (left) that infiltrates the renal parenchyma (right). b H&E staining (×20): neoplastic cells forming vascular structures with epithelioid features and highly atypical nuclei. c H&E staining (×10): malignant cells of angiosarcoma (left) juxtaposed to benign spindle cells population of schwannoma (right). d H&E staining (×40): fine needle aspiration biopsy of the pulmonary lesion shows neoplastic cells

Fig. 3

a, b Immunohistochemical staining (×10): neoplastic cells show immunopositivity for CD34 and cytokeratin. c Immunohistochemical staining (×10): schwannoma cells with strong, diffuse S100 immunoreactivity. d Immunohistochemical staining (×40): neoplastic cells present in fine-needle aspiration biopsy of the pulmonary lesion are CD34 positive

Conclusions

Angiosarcoma is an infrequent neoplasm with a very poor prognosis which is why it has been very rarely described in the kidney. The diagnosis of this lesion is extremely difficult if not impossible when considering just the clinical and radiological features. So, it is often referred to post-operative time, and pathological examination remains the gold standard. The occurrence of an angiosarcoma in a pre-existent schwannoma is an exceptionally rare event with an unknown pathogenesis. In view of the rarity of the lesion, an extensive review of the literature was undertaken through a MEDLINE search using the search terms “primary renal schwannoma/primary schwannoma of the kidney,” “primary renal angiosarcoma/primary angiosarcoma of the kidney,” and “angiosarcoma arising in schwannoma.” Only reports in English have been taken into account. In Tables 1, 2, and 3 are listed the cases reported in the literature specifying the source and the clinical features of each case.
Table 1

Cases of primary schwannoma of the kidney

Author

Sex

Age (years)

Side

Location

Year

Verze et al. [12]

Male

59

Right

Parenchymal

2014

Wang et al. [13]

Male

66

Left

Parenchymal

2013

Mikkilineni et al. [14]

Female

36

Right

Parenchymal

2013

Yang et al. [15]

Female

40

Left

Hilum

2012

Nayyar et al. [16]

Female

44

Right

Hilum

2011

Sfoungaristos et al. [17]

Female

55

Left

Parenchymal

2011

Qiguang et al. [18]

Male

34

Right

Hilum

2010

Gobbo et al. [19]

Female

27

Left

Hilum

2008

Gobbo et al. [19]

Female

35

Right

Hilum

2008

Gobbo et al. [19]

Female

39

Left

Parenchymal

2008

Hung et al. [20]

Female

36

Left

Parenchymal

2008

Alvarado-Cabrero et al. [21]

Male

45

Left

Parenchymal

2000

Alvarado-Cabrero et al. [21]

Female

40

Left

Parenchymal

2000

Alvarado-Cabrero et al. [21]

Male

84

Right

Parenchymal

2000

Alvarado-Cabrero et al. [21]

Female

14

Right

Parenchymal

2000

Singer et al. [22]

Female

70

Left

Capsule

1996

Bezzi et al. [23]

Male

60

Right

Hilum

1996

Kitagawa et al. [24]

Male

51

Left

Hilum

1990

Ma et al. [25]

Male

67

Right

Parenchymal

1990

Somers et al. [26]

Female

55

Left

Parenchymal

1988

Phillips et al. [27]

Male

56

Left

Hilum

1955

Table 2

Cases of primary angiosarcoma of the kidney

Author

Sex

Age (years)

Side

Year

Clinical presentation

Zhang et al. [28]

Male

52

Left

2014

Leg pain and flank pain

Qayyum et al. [29]

Female

86

Right

2014

Fatigue, dizziness, weight loss

Liu et al. [30]

Male

75

Right

2014

Gross hematuria

Sabharwal et al. [31]

Male

67

Left

2013

Flank pain, weight loss

Chaabouni et al. [32]

Male

59

Right

2013

Flank pain, gross hematuria

Singh et al. [33]

Male

83

Left

2012

Acute chest pain, dyspnea

Douard et al. [34]

Male

60

Right

2012

Hodgkin’s lymphoma history

Zenico et al. [35]

Male

56

Left

2011

Hodgkin’s lymphoma history

Papadimitriou [36]

Male

68

Left

2009

Flank pain

Fukunaga [37]

Male

61

Left

2009

Hypertension

Leggio et al. [38]

Male

60

Left

2006

After trauma

Akkad et al. [39]

Male

58

Right

2006

Asymptomatic

Johnson et al. [40]

Male

50

Left

2002

Flank pain, hemoptysis

Aksoy et al. [41]

Male

55

Left

2002

Spontaneous rupture

Aydogdu et al. [42]

Male

77

Left

1999

Gross hematuria, flank pain

Cerilli et al. [43]

Male

67

Right

1998

Gross hematuria, flank pain

Tsuda et al. [44]

Male

77

Left

1997

Gross hematuria, renal failure

Mordkin et al. [45]

Male

75

Left

1997

Weight loss, fever

Hiratsuka et al. [46]

Female

59

Right

1997

Hematuria

Martinez-Piñeiro et al. [47]

Male

66

Left

1995

Asthenia

Kern et al. [48]

Male

69

Left

1995

Flank pain, hematuria, weight loss

Kern et al. [48]

Male

56

Left

1995

Hematuria

Adjiman et al. [49]

Male

36

Right

1990

Flank pain, cough, hemoptysis

Desai et al. [50]

Male

54

Left

1989

Flank pain, microhematuria

Cason et al. [51]

Male

46

Left

1987

Flank pain, weight loss, fever

Terris et al. [52]

Male

47

Left

1986

Flank pain

Allred et al. [53]

Male

67

Right

1981

Flank pain, hematuria

Askari et al. [54]

Male

24

Right

1980

Hematuria

Peters et al. [55]

Male

74

Left

1974

Weight loss

Table 3

Cases of angiosarcoma arising in schwannoma

Author

Sex

Age (years)

Location

Year

Mahajan et al. [56]

Male

41

Neck, vagus nerve

2014

Li et al. [57]

Male

67

Right abdominal adrenergic nerve

2012

Li et al. [57]

Male

38

Right inguinal sciatic nerve

2012

Li et al. [57]

Male

55

Left neck, vagus nerve

2012

Lee et al. [58]

Male

73

Left thigh, sciatic nerve

2007

Ito et al. [59]

Male

66

Intracranial vestibular nerve

2007

McMenamin et al. [60]

Female

74

Right neck, vagus nerve

2001

McMenamin et al. [60]

Female

40

Right thigh, sciatic nerve

2001

McMenamin et al. [60]

Female

17

Right neck, phrenic nerve

2001

McMenamin et al. [60]

Female

39

Right buttock

2001

Ruckert et al. [61]

Male

50

Right neck, vagus nerve

2000

Mentzel et al.

Female

73

Right neck, vagus nerve

1999

Mentzel et al.

Male

63

Right neck, vagus nerve

1999

Trassard et al. [62]

Male

65

Right thigh, sciatic nerve

1996

Twenty-one cases of renal schwannoma have been reported in literature (Table 1) [1227]. Tumors involved patients ranging in age from 14 to 84 years, with a median age of 48 years and a slight predominance in females (male to female ratio of 0.75:1). Renal schwannomas were mainly located in the parenchyma and less frequently in the hilum.

Twenty-nine cases of primary renal angiosarcoma have been reported in literature [2855]. The median age of patients was 61.5 years with an age range comprised from 24 to 86 years. The great majority of tumors have been found in males with a male to female ratio of 13.5:1 (27 males and 2 females). Angiosarcoma was seen to arise preferably in the left kidney (right to left ratio of 0.5:1). The most common symptoms reported were the classical symptoms due to a renal mass like flank pain and hematuria, while more rarely there were symptoms related to the presence of metastasis at time of diagnosis like cough, hemoptysis, and dizziness. Three cases were asymptomatic, and the lesions have been found as incidental findings during diagnostic tests conducted for other reasons.

Angiosarcomas arise very rarely in the context of a pre-existing schwannoma. To the best of our knowledge, only 14 cases have been reported in literature to date [5662]. In all these cases, an angiosarcomatous component had an epithelial morphology. Patients were aged between 17 and 74 with a median age of 55 and a male to female ratio of 1.8:1. The locations of the lesions included the neck, leg, buttock, intracranial, abdominal cavity, and inguinal region; no case has been previously reported in the kidney.

Consent

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Declarations

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

(1)
Division of Pathology, S. Maria del Popolo degli Incurabili Hospital ASL Na1
(2)
Division of Urology, S. Maria del Popolo degli Incurabili Hospital ASL Na1
(3)
Division of Pathology, School of Medicine, University Federico II

References

  1. Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F. WHO classification of tumours of soft tissue and bone, 4th edition. International Agency for Research on Cancer (IARC); Philadephia, U.S.A., 2013.Google Scholar
  2. Eldridge R. Central neurofibromatosis with bilateral acoustic neuroma. Adv Neurol. 1981;29:57–65.PubMedGoogle Scholar
  3. De Vries M, van der Mey AG, Hogendoorn PC. Tumor biology of vestibular schwannoma: a review of experimental data on the determinants of tumor genesis and growth characteristics. Otol Neurotol. 2015;36(7):1128–36.View ArticlePubMedGoogle Scholar
  4. McMenamin ME, Fletcher CDM. Expanding the spectrum of malignant change in schwannomas. Am J Surg Pathol. 2001;25(1):13–25.View ArticlePubMedGoogle Scholar
  5. Mentzel T, Katenkamp D. Intraneural angiosarcoma and angiosarcoma arising in benign and malignant peripheral nerve sheath tumours: clinicopathological and immunoistochemical analysis of four cases. Histopathology. 1999;35:114–20.View ArticlePubMedGoogle Scholar
  6. Hornick JL. Practical soft tissue pathology: a diagnostic approach. Philadelphia: Elsevier Saunders; 2013.Google Scholar
  7. Toro JR, Travis LB, Wu HJ, Zhu K, Fletcher CD, Devesa SS. Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978–2001: an analysis of 26758 cases. Int J Cancer. 2006;119:2922–30.View ArticlePubMedGoogle Scholar
  8. Deyrup AT, Miettinen M, North PE, Khoury JD, Tighiouart M, Spunt SL, et al. Angiosarcomas arising in the viscera and soft tissue of children and young adults: a clinicopathologic study of 15 cases. Am J Surg Pathol. 2009;33:264–9.View ArticlePubMedGoogle Scholar
  9. Styring E, Seinen J, Dominguez-Valentin M, Domanski HA, Jonsson M, von Steyern FV, et al. Key roles for MYC, KIT and RET signaling in secondary angiosarcomas. Br J Cancer. 2014;111(2):407–12.PubMed CentralView ArticlePubMedGoogle Scholar
  10. Fletcher CD. The evolving classification of soft tissue tumours; an update based on the new 2013 WHO classification. Histopathology. 2014;64(1):2–11.View ArticlePubMedGoogle Scholar
  11. Meis-Kindblom JM, Kindblom LG. Angiosarcoma of the soft tissue: a study of 80 cases. Am J Surg Pathol. 1998;22:683–97.View ArticlePubMedGoogle Scholar
  12. Verze P, Somma A, Imbimbo C, Mansueto G, Mirone V, Insabato L. Melanotic schwannoma: a case of renal origin. Clin Genitourin Cancer. 2014;12(1):37–41.View ArticleGoogle Scholar
  13. Wang Y, Zhu B. A case of schwannoma in kidney. Quant Imaging med Surg. 2013;3(3):180–1.PubMed CentralPubMedGoogle Scholar
  14. Mikkilineni H, Thupili CR. Benign renal schwannoma. J Urol. 2013;189(1):317–8.View ArticlePubMedGoogle Scholar
  15. Yang HJ, Lee MH, Kim DS, Lee HJ, Lee JH, Jeon YS. A case of renal schwannoma. Korean J Urol. 2012;53(12):875–8.PubMed CentralView ArticlePubMedGoogle Scholar
  16. Nayyar R, Khattar N, Sood R, Bhardwaj M. Cystic retroperitoneal renal hilar ancient schwannoma: report of a rare case with atypical presentation masquerading as simple cyst. Indian J Urol. 2011;27(3):404–6.PubMed CentralView ArticlePubMedGoogle Scholar
  17. Sfoungaristos S, Kavouras A, Geronatsiou K, Perimenis P. Schwannoma of the kidney with magnetic resonance images of non-homogenous renal mass—a case presentation. Praque Med Rep. 2011;112(2):137–43.Google Scholar
  18. Qiquang C, Zhe Z, Chuize K. Neurilemoma of the renal hilum. Am Surg. 2010;76(11):197–8.Google Scholar
  19. Gobbo S, Eble JN, Huang J, Grignon DJ, Wang M, Martignoni G, et al. Schwannoma of the kidney. Mod Pathol. 2008;21(6):779–83.View ArticlePubMedGoogle Scholar
  20. Hung SF, Chung SD, Lai MK, Chueh SC, Yu HJ. Renal schwannoma: case report and literature review. Urology. 2008;72(3):716. e3-716.e6.View ArticlePubMedGoogle Scholar
  21. Alvarado-Cabrero I, Folpe AL, Srigley JR, Gaudin P, Philip AT, Reuter VE, et al. Intrarenal schwannoma: a report of four cases including three cellular variants. Mod Pathol. 2000;13(8):851–6.View ArticlePubMedGoogle Scholar
  22. Singer AJ, Anders KH. Neurilemmoma of the kidney. Urology. 1996;47:575–81.View ArticlePubMedGoogle Scholar
  23. Bezzi M, Orsi F, Rossi P. Nonencapsulated ancient schwannoma of the renal sinus. AJR Am J Roentgenol. 1996;166(6):1498.View ArticlePubMedGoogle Scholar
  24. Kitagawa K, Yamahana T, Hirano S, Kawaguchi S, Mikawa I, Masuda S, et al. MR imaging of neurilemmoma arising from the renal hilus. J Comput Assist Tomogr. 1990;14(5):830–2.View ArticlePubMedGoogle Scholar
  25. Ma KF, Tse CH, Tsui MS. Neurilemmoma of kidney—a rare occurrence. Histopathology. 1990;17:378–80.View ArticlePubMedGoogle Scholar
  26. Somers WJ, Terpenning B, Lowe FC, Romas NA. Renal parenchymal neurilemmoma: a rare and unusual kidney tumor. J Urol. 1988;139(1):109–10.PubMedGoogle Scholar
  27. Philips CA, Baumrucker G. Neurilemmoma (arising in the hilus of left kidney). J Urol. 1955;73:671–3.Google Scholar
  28. Zhang HM, Yan Y, Luo M, Xu YF, Peng B, Zheng JH. Primary angiosarcoma of the kidney: case analysis and literature review. Int J Clin Exp Pathol. 2014;7(7):3555–62.PubMed CentralPubMedGoogle Scholar
  29. Qayyum S, Parikh JG, Zafar N. Primary renal angiosarcoma with extensive necrosis: a difficult diagnosis. Case Rep Pathol. 2014;416170.Google Scholar
  30. Liu H, Huang X, Chen H, Wang X, Chen L. Epithelioid angiosarcoma of the kidney: a case report and literature review. Oncol Lett. 2014;8(3):1155–8.PubMed CentralPubMedGoogle Scholar
  31. Sabharwal S, John NT, Kumar RM, Kekre NS. Primary renal angiosarcoma. Indian J Urol. 2013;29:145–7.PubMed CentralView ArticlePubMedGoogle Scholar
  32. Chaabouni A, Rebai N, Chabchoub K, Fourati M, Bouacida M, Slimen MH, et al. Primary renal angiosarcoma: case report and literature review. Can Urol Assoc J. 2013;7:E430–2.PubMed CentralView ArticlePubMedGoogle Scholar
  33. Singh C, Xie L, Schmechel SC, Manivel JC, Pambuccian SE. Epithelioid angiosarcoma of the kidney: a diagnostic dilemma in fine-needle aspiration cytology. Diagn Cytopathol. 2012;40(2):E131–9.View ArticlePubMedGoogle Scholar
  34. Douard A, Pasticier G, Deminiere C, Wallerand H, Ferriere JM, Bernhard JC. Primary angiosarcoma of the kidney: case report and literature review. Prog Urol. 2012;22:438–41.View ArticlePubMedGoogle Scholar
  35. Zenico T, Saccomanni M, Salomone U, Bercovich E. Primary renal angiosarcoma: case report and review of world literature. Tumori. 2011;97:e6–9.PubMedGoogle Scholar
  36. Papadimitriou VD, Stamatiou KN, Takos DM, Adamopoulos VM, Heretis IE, Sofras FA. Angiosarcoma of the kidney: a case report and review of literature. Urol J. 2009;6:223–5.PubMedGoogle Scholar
  37. Fukunaga M. Angiosarcoma of the kidney with minute clear cell carcinomas: a case report. Pathol Res Pract. 2009;205:347–51.View ArticlePubMedGoogle Scholar
  38. Leggio L, Addolorato G, Abenavoli L, Ferrulli A, D’Angelo C, Mirijello A, et al. Primary renal angiosarcoma: a rare malignancy. A case report and review of the literature. Urol Oncol. 2006;24:307–12.View ArticlePubMedGoogle Scholar
  39. Akkad T, Tsankov A, Pelzer A, Bartsch R, Steiner H. Early diagnosis and straight forward surgery of an asymptomatic primary angiosarcoma of the kidney led to long-term survival. Int J Urol. 2006;13:1112–4.View ArticlePubMedGoogle Scholar
  40. Johnson W, Gaertner EM, Crothers BA. Fine-needle aspiration of renal angiosarcoma. Arch Pathol Lab Med. 2002;126:478–80.PubMedGoogle Scholar
  41. Aksoy Y, Gursan N, Ozbey I, Bicgi O, Keles M. Spontaneous rupture of a renal angiosarcoma. Urol Int. 2002;68:60–2.View ArticlePubMedGoogle Scholar
  42. Aydogdu I, Turhan O, Sari R, Ates M, Turk M. Coincidental acute myeloblastic leukemia in a patient with renal angiosarcoma. Haematologia. 1999;29:313–7.PubMedGoogle Scholar
  43. Cerilli LA, Huffman HT, Anand A. Primary renal angiosarcoma: a case report with immunohistochemical, ultrastructural and cytogenetic features and review of the literature. Arch Pathol Lab Med. 1998;122:929–35.PubMedGoogle Scholar
  44. Tsuda N, Chowdhury PR, Hayashi T, Anami M, Iseki M, Koga S, et al. Primary renal angiosarcoma: a case report and review of the literature. Pathol Int. 1997;47:778–83.View ArticlePubMedGoogle Scholar
  45. Mordkin RM, Dahut WL, Lynch JH. Renal angiosarcoma: a rare primary genitourinary malignancy. South Med J. 1997;90:1159–60.View ArticlePubMedGoogle Scholar
  46. Hiratsuka Y, Nishimura H, Kajiwara I, Matsouka H, Kawamura K. Renal angiosarcoma: a case report. Int J Urol. 1997;4:90–3.View ArticlePubMedGoogle Scholar
  47. Martinez-Piñeiro L, Lopez-Ferrer P, Picazo ML, Martinez-Piñeiro JA. Primary renal angiosarcoma. Case report and review of the literature. Scand J Urol Nephrol. 1995;29:103–8.View ArticlePubMedGoogle Scholar
  48. Kern SB, Gott L, Faulkner 2nd J. Occurrence of primary renal angiosarcoma in brothers. Arch Pathol Lab Med. 1995;119:75–8.PubMedGoogle Scholar
  49. Adjiman S, Zerbib M, Flam T, Brochard M, Desligneres S, Boissonnas A, et al. Genitourinary tumors and HIV1 infection. Eur Urol. 1990;18:61–3.PubMedGoogle Scholar
  50. Desai MB, Chess Q, Naidich JB, Weiner R. Primary renal angiosarcoma mimicking a renal cell carcinoma. Urol Radiol. 1989;11:30–2.View ArticlePubMedGoogle Scholar
  51. Cason JD, Waisman J, Plaine L. Angiosarcoma of the kidney. Urology. 1987;30:281–3.View ArticlePubMedGoogle Scholar
  52. Terris D, Plaine L, Steinfeld A. Renal angiosarcoma. Am J Kidney Dis. 1986;8:131–3.View ArticlePubMedGoogle Scholar
  53. Allred CD, Cathey WJ, McDivitt RW. Primary fenal angiosarcoma: a case report. Hum Pathol. 1981;12:665–8.View ArticlePubMedGoogle Scholar
  54. Askari A, Novick A, Braun W, Steinmuller D. Late ureteral obstruction and hematuria from de novo angiosarcoma in a renal transplant patient. J Urol. 1980;124:717–9.PubMedGoogle Scholar
  55. Peters HJ, Nuri M, Munzenmaier R. Hemangioendothelioma of the kidney: a case report and review of the literature. J Urol. 1974;112:723–6.PubMedGoogle Scholar
  56. Mahajan V, Rao S, Gupta P, Munjal M, Agrawal S. Angiosarcoma developing in a vagal schwannoma: a rare case report. Head Neck Pathol. 2014;Nov. [Epub ahead of print]Google Scholar
  57. Li C, Chen Y, Zhang H, Zheng X, Wang J. Epithelioid angiosarcoma arising in schwannoma: report of three Chinese cases with review of literature. Pathol Int. 2012;62(7):500–5.View ArticlePubMedGoogle Scholar
  58. Lee FY, Wen MC, Wang J. Epithelioid angiosarcoma arising in a deep-seated plexiform schwannoma: a case report and literature review. Hum Pathol. 2007;38:1096–101.View ArticlePubMedGoogle Scholar
  59. Ito T, Tsutsumi T, Ohno K, Takizawa T, Kitamura K. Intracranial angiosarcoma arising from a schwannoma. J Laryngol Otol. 2007;121:68–71.View ArticlePubMedGoogle Scholar
  60. McMenamin ME, Fletcher CD. Expanding the spectrum of malignant change in schwannomas: epithelioid malignant change, epithelioid malignant peripheral nerve sheath tumor and epithelioid angiosarcoma: a study of 17 cases. Am J Surg Pathol. 2001;25:13–25.View ArticlePubMedGoogle Scholar
  61. Ruckert RI, Fleige B, Rogalla P, Woodruff JM. Schwannoma with angiosarcoma. Report of a case and comparison with other types of nerve tumors with angiosarcoma. Cancer. 2000;89(7):1577–85.View ArticlePubMedGoogle Scholar
  62. Trassard M, Le Doussal V, Bui BN, Coindre JM. Angiosarcoma arising in a solitary schwannoma (neurilemoma) of the sciatic nerve. Am J Surg Pathol. 1996;20:1412–27.View ArticlePubMedGoogle Scholar

Copyright

© Iannaci et al. 2016

Advertisement