Introduction:</span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Primary renal synovialosarcoma (SVS) is a rare and ag...Introduction:</span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Primary renal synovialosarcoma (SVS) is a rare and aggressive disease in which the metastatic potential is very high. Its diagnosis is based on morphological and molecular studies. No therapeutic consensus has yet been established for this histological variant of renal cancer. We describe our experience with a patient followed at the Mohamed IV Center for cancer treatment for primary monophasic synovialosarcoma of the kidney. </span><span><span style="font-family:Verdana;">Case Presen</span><span style="font-family:Verdana;">tation: </span></span><span style="font-family:Verdana;">In October 2020, a 58-year-old patient with hypertension unde</span><span style="font-family:Verdana;">r treat</span><span style="font-family:Verdana;">ment, consulted for right back pain without hematuria or calculus emission. The initial examination found a slight right lumbar tenderness. Thoraco-abdominal computed tomography revealed a cystic lesion of the superior</span><span style="font-family:Verdana;"> pole of the right kidney without secondary lesions. Surgical treatment consisted of an enlarged </span><span style="font-family:Verdana;">right total nephrectomy using a bi-subcostal approach. The post-operative</span><span style="font-family:Verdana;"> consequences were simple. Histologically, it was a poorly differentiated cystic malignant tumor process measuring 17 cm long axis. The limits were healthy as well as the adrenal. Immunohistology made it possible to retain a monophasic synovialosarcoma. However</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">the patient did not receive genetic analysis. Given the poor prognosis of these tumors, treatment with adjuvant che</span><span style="font-family:Verdana;">motherapy and radiotherapy has been imposed;as indicated in our case.</span> <span style="font-family:Verdana;">Conclusion: </span><span style="font-family:Verdana;">Primary kidney SVS is a rare, aggressive disease with a poor prognosis. However, the prognosis may</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">be improved by multimodal treatment. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">A </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">positive diagnosis is difficult and can be confused with other types of renal carcinoma hence the interest </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">in</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> molecular biology.展开更多
Background:Renal cell carcinoma(RCC)has traditionally been considered to be radioresistant.Response rates are believed to be improved by a high dose of stereotactic body radiotherapy(SBRT).A retrospective analysis was...Background:Renal cell carcinoma(RCC)has traditionally been considered to be radioresistant.Response rates are believed to be improved by a high dose of stereotactic body radiotherapy(SBRT).A retrospective analysis was conducted of patients treated with SBRT for metastatic disease from RCC.Material and methods:We reviewed records from 20 patients who underwent SBRT for a total of 30 RCC metastases from 2015 to 2020.Patients were included who had a confirmed primary RCC and radiographic evidence of metastasis,either synchronous or metachronous.The most common SBRT fractionation was 30 Gy in 3 fractions.Results:Median agewas 60 years(range,40-77 years)and 60%were male.After amedian follow-up of 18 months(range,3-36 months),overall survival was estimated to be 85%and 70%,at 1 and 2 years,respectively,and local control at 2 years was 83.33%.Only 5 patients had documented progression of disease,all of whom received biologically effective dose inferior to 100 Gy,and no patients treated with a higher biologically effective dose had disease,which progressed.Themost common acute toxicity was grade 1 fatigue(20%).No grade 3 or higher acute toxicity occurred.Conclusions:Treatment with SBRT in patients with RCC metastases yielded a high local control rate,promising survival rate,and low toxicity.展开更多
文摘Introduction:</span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Primary renal synovialosarcoma (SVS) is a rare and aggressive disease in which the metastatic potential is very high. Its diagnosis is based on morphological and molecular studies. No therapeutic consensus has yet been established for this histological variant of renal cancer. We describe our experience with a patient followed at the Mohamed IV Center for cancer treatment for primary monophasic synovialosarcoma of the kidney. </span><span><span style="font-family:Verdana;">Case Presen</span><span style="font-family:Verdana;">tation: </span></span><span style="font-family:Verdana;">In October 2020, a 58-year-old patient with hypertension unde</span><span style="font-family:Verdana;">r treat</span><span style="font-family:Verdana;">ment, consulted for right back pain without hematuria or calculus emission. The initial examination found a slight right lumbar tenderness. Thoraco-abdominal computed tomography revealed a cystic lesion of the superior</span><span style="font-family:Verdana;"> pole of the right kidney without secondary lesions. Surgical treatment consisted of an enlarged </span><span style="font-family:Verdana;">right total nephrectomy using a bi-subcostal approach. The post-operative</span><span style="font-family:Verdana;"> consequences were simple. Histologically, it was a poorly differentiated cystic malignant tumor process measuring 17 cm long axis. The limits were healthy as well as the adrenal. Immunohistology made it possible to retain a monophasic synovialosarcoma. However</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">the patient did not receive genetic analysis. Given the poor prognosis of these tumors, treatment with adjuvant che</span><span style="font-family:Verdana;">motherapy and radiotherapy has been imposed;as indicated in our case.</span> <span style="font-family:Verdana;">Conclusion: </span><span style="font-family:Verdana;">Primary kidney SVS is a rare, aggressive disease with a poor prognosis. However, the prognosis may</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">be improved by multimodal treatment. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">A </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">positive diagnosis is difficult and can be confused with other types of renal carcinoma hence the interest </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">in</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> molecular biology.
文摘Background:Renal cell carcinoma(RCC)has traditionally been considered to be radioresistant.Response rates are believed to be improved by a high dose of stereotactic body radiotherapy(SBRT).A retrospective analysis was conducted of patients treated with SBRT for metastatic disease from RCC.Material and methods:We reviewed records from 20 patients who underwent SBRT for a total of 30 RCC metastases from 2015 to 2020.Patients were included who had a confirmed primary RCC and radiographic evidence of metastasis,either synchronous or metachronous.The most common SBRT fractionation was 30 Gy in 3 fractions.Results:Median agewas 60 years(range,40-77 years)and 60%were male.After amedian follow-up of 18 months(range,3-36 months),overall survival was estimated to be 85%and 70%,at 1 and 2 years,respectively,and local control at 2 years was 83.33%.Only 5 patients had documented progression of disease,all of whom received biologically effective dose inferior to 100 Gy,and no patients treated with a higher biologically effective dose had disease,which progressed.Themost common acute toxicity was grade 1 fatigue(20%).No grade 3 or higher acute toxicity occurred.Conclusions:Treatment with SBRT in patients with RCC metastases yielded a high local control rate,promising survival rate,and low toxicity.
