Renal Medullary Carcinoma in Sickle Cell Disease: Radiological and Pathological Findings

We report two cases of renal medullary carcinoma col-lected from Almana General Hospital in KSA. The incidence of sickle cell trait in KSA is high; however, this tumor is rare and only case reports were described in literature. Both patients were males with the ages of 32 and 25 years. The most frequent presenting symptoms were gross hematuria and flank pain. The duration of symptoms ranged from 3 weeks to 2 months. The tumors were poorly circumscribed arising centrally in the renal medulla. Sizes in both patients were 6 and 8 cm and hemorrhage and necrosis were common findings. Both cases described showed sickle red blood cells in the tissue and one patient was confirmed to have sickle cell disease and the other was sickle cell trait. Both cases showed the characteristic reticular pattern, reminiscent of yolk sac testicular tumors of reticular type with areas of microcystic, tubular, trabecular, solid and adenoid-cystic patterns, and stromal desmoplasia. The characteristic collections of neutrophiles with foci of necrosis and microabscesses were seen. One patient died within 6 months after diagnosis.