Case Report
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World J Radiol. Oct 28, 2014; 6(10): 846-849
Published online Oct 28, 2014. doi: 10.4329/wjr.v6.i10.846
Peripheral primitive neuroectodermal tumor of the kidney presenting with pulmonary tumor embolism: A case report
Sathya Chinnaa, Chandan J Das, Sanjay Sharma, Prabhjot Singh, Amlesh Seth, Suvendu Purkait, Sandeep R Mathur
Sathya Chinnaa, Chandan J Das, Sanjay Sharma, Department of Radiology, All India Institute Of Medical Sciences, New Delhi 110029, India
Prabhjot Singh, Amlesh Seth, Department of Urology, All India Institute Of Medical Sciences, New Delhi 110029, India
Suvendu Purkait, Sandeep R Mathur, Department of Pathology, All India Institute Of Medical Sciences, New Delhi 110029, India
Author contributions: Chinnaa S and Das CJ did the literature search and prepared the manuscript; Sharma S edited the manuscript; Singh P and Seth A operated on the patient; Purkait S and Mathur SR contributed to the pathological diagnosis.
Correspondence to: Chandan J Das, Assistant Professor, Department of Radiology, All India Institute of Medical Sciences, Aurobindo Marg, New Delhi 110029, India. dascj@yahoo.com
Telephone: +91-11-26593628 Fax: +91-11-26588663
Received: February 19, 2014
Revised: April 8, 2014
Accepted: August 27, 2014
Published online: October 28, 2014
Abstract

Peripheral primitive neuroectodermal tumor (PNET) of the kidney is a rare, aggressive tumor known for its recurrence and metastatic potential. Despite the frequency of venous extension to the renal veins and inferior vena cava, pulmonary tumor embolism at the initial presentation is not common. We report a case of 22-year-old female with PNET of the kidney who presented with tumor embolism in the inferior vena cava (IVC) and bilateral pulmonary artery. The patient underwent surgical resection and histopathological analysis confirmed the presence of tumor within the IVC and pulmonary arteries. The patient received adjuvant chemotherapy and is currently doing well on follow-up.

Keywords: Primitive neuroectodermal tumor; Pulmonary tumor embolism; Computed tomography

Core tip: Traditionally, an aggressive renal mass with pulmonary tumor embolism is an entity well described in renal cell carcinomas. However, renal primitive neuroectodermal tumor (PNET), a rare and aggressive tumor, can have a similar presentation. The severity of the clinical manifestations of pulmonary tumor embolism is highly variable and less predictable. Bland thrombus often mimics tumor emboli in imaging and histopathology is often confirmatory. Tumoral extension into the pulmonary artery is not necessarily associated with pulmonary metastasis. Surgical removal of the thrombus along with the primary tumor followed by adjuvant chemotherapy may prolong the survival in these patients.