Renal sarcomas are very rare malignant tumours with a very poor prognosis. Renal leiomyosarcoma, a malignant tumour of smooth muscle origin, is the most common histological type. The article reports a case of leiomyosarcoma of renal location, with a review of the literature. A 38-year-old female patient, with no previous pathological history, consulted the nephrology department of the Teaching Hospital of Lomé for abdominal pain that had been present for 4 years. Histology showed a tumour proliferation of fasciculated architecture, made of spindle cells arranged in long bundles, with cytonuclear atypia and cytoarchitectural abnormalities. Immunohistochemical examination showed positive staining for smooth muscle actin, h-caldesmone, desmin and CD34 and negative for pancytokeratin (AE1/AE3), myogenin and PS100. Renal leiomyosarcoma is an exceptional malignancy. It remains the most common renal sarcoma, the differential diagnosis of which is based on immunohistochemical findings.
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Primary renal leiomyosarcoma is a rare but highly aggressive tumor with a poor prognosis. Early detection and surgical excision provide the most effective initial treatment. However, vigilant postoperative surveillance is critical due to the elevated risk of tumor recurrence and metastasis, as seen in this case.
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