Mucinous tubular and spindle cell carcinoma of the kidney: A case report and concise review of literature

@#Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare neoplasm of the kidney. Recognition of this rare entity is important with regards to a patient’s prognosis and therapeutic management.

Spitzoid melanocytic tumors / 中华皮肤科杂志

Clinical and histological features of Spitz nevi, atypical Spitz tumors and spitzoid melanoma overlap each other, making their identification challenging. Combined with clinical and histological features of spitzoid melanocytic tumors, this review summarizes research progress in their immunohistochemical features and application of fluorescence in situ hybridization in their identification.

Clinicopathological characteristics and prognosis analysis of mucinous tubular and spindle cell carcinoma of the kidney / 中华泌尿外科杂志

Objective:To explore the clinicopathological features and prognosis of renal mucinous tubular spindle cell carcinoma (MTSCC).Methods:The clinical data of 16 patients with MTSCC admitted to the First Affiliated Hospital of Zhengzhou University from July 2013 to July 2022 were retrospectively analyzed. There were six male cases and ten female cases. The mean age was (56.4±11.4) years old. Among them, 10 cases were asymptomatic, two complained of hematuria, three complained of lumbar pain, and one complained of lower limb pain. Twelve cases underwent preoperative enhanced CT examination, 6 cases of ultrasound examination, 3 cases of MRI examination, and 1 case of bone scan. Imaging manifestations showed that the masses were round or round-like with clear borders. Two cases combined with hemorrhage and three cases combined with calcification. Five cases showed exophytic growth, 10 cases partially exophytic, and 1 case completely endophytic. The maximum diameter of the tumor was (65.7±27.4) mm. The tumors were located in the left kidney in 11 cases and in the right kidney in 5 cases. The tumors were mildly delayed-enhancing under enhanced CT, long/short T1 signal mixed with long/short T2 signal under MRI, and diffusion-limited high signal under DWI. The tumors were hypoechoic masses without obvious blood flow signals under ultrasound. Twelve cases were diagnosed as renal occupying neoplasms, 2 cases were suggested as lack of blood supply renal tumor, and one was considered renal tumor rupture and bleeding. In one case, a bone scan suggested metastasis to the thoracic spine and pelvis. The metastatic renal tumor was diagnosed, and a renal puncture was performed to clarify the pathology. Eleven patients underwent laparoscopic radical nephrectomy, and 4 patients underwent partial nephrectomy. One case was metastasized without surgery and treated with apatinib mesylate and zoledronic acid.Results:The postoperative pathological specimens showed grayish, grayish-yellow, or grayish-red masses with a soft or medium texture. No perinephric, ureteral, or adrenal invasion was seen in all tumors. Microscopically, the tumor cells were round and ovoid. The tumor cells were arranged in tubular and striated shapes, and mucus pools were locally visible. No sarcomatous component was seen in all tumors. There were 9 patients with pT 1N 0M 0, 6 patients with pT 2N 0M 0, and 1 patient with pT 1N 0M 1. After operation, 2 patients with pT 2N 0M 0, who underwent laparoscopic radical nephrectomy were treated with pazopanib and sunitinib, respectively. All patients were followed up for a median of 50.7(25.8, 75.0)months, 15 patients were free of recurrent metastases, and 1 patient with pre-puncture metastasis died due to tumor progression of multiple pulmonary and bone metastases, with a survival of 16.9 months. Conclusions:Renal MTSCC is rare, mostly found on physical examination, with female patients predominantly, and imaging shows a lack of blood supply tumor. Surgery is the primary treatment method. Partial nephrectomy or radical nephrectomy could be chosen according to the tumor stage, kidney function, and patient's underlying condition, and patients have a good prognosis.

Large mucinous tubular and spindle cell carcinoma of left kidney: a case report / 中华泌尿外科杂志

In November 2019, we received and treated a patient with MTSCC of the left kidney. The tumor was located at the upper pole of the left kidney, with a size of 23.3 cm×18.0 cm×21.8 cm. She underwent transperitoneal radical nephrectomy. There was no local recurrence or distant metastasis during the follow-up of 3 years and 2 months. MTSCC of the kidney is a rare subtype of renal carcinoma, with slower disease progression, a clear and smooth rim, and fewer invasion or metastasis. Its final diagnosis should depend on pathology examination. Surgical treatment is the only effective intervention for this disease at present.

High grade spindle cell carcinoma of the ovary arising in an endometrioid cystadenoma: A case report

@#Spindle Cell Carcinoma of the Ovary is arate form of cancer with controversial histogenesis. It shares the histologic, cytologic, and molecular properties of both epithelial and mesenchymal differentiation of ovarian neoplasms, which makes diagnosis very challenging among pathologists. Endometrioid cystadenoma is a benign ovarian neoplasms classified under epithelial ovarian tumors.Malignant transformation of benign ovarian neoplasms is known as a rare complication, occurring in approximately 0.9% of patients with ovarian endometriosis. Clear cell adenocarcinoma is the most common endometriosis-associated ovarian cancer followed by endometrioid cancer. This is the case of a 56-year old post-menopausal patient initially presenting with increasingabdominal girth. Whole abdominal ultrasound revealed a large pelvo-abdominal mass. Transvaginal and transabdominal ultrasound findings of bilateral ovarian new growth with benign sonologic features. The patient underwent bilateral salpingo-oophorectomy. Histopathologic findings of the specimen submitted revealed high-grade spindle cell carcinoma arising in an endometrioid cystadenoma of the right ovary, and endometrioid cystadenofibroma with focal epithelial proliferation.

Clinicopathological profile of hyperpigmented skin lesions- A prospective study

Introduction: Hyperpigmentation is one of the most common reac?on to inflammatory, benign and malignant lesions of the skin. These disorders comprise heterogeneous group of diseases of epidermal and dermal hyperpigmenta?on divided into various types according to e?ology and pathology. Correct diagnosis of these hyperpigmented lesions is linked to histopathologic examina?on of skin biopsies with clinical correla?on. Aim: To study the spectrum of hyperpigmented skin lesions with reference to age and sex distribu?on. Materials and Methods: This prospec?ve cohort study was conducted at Department of Pathology, at Alluri Sitaramaraju Academy of Medical Sciences, Eluru, Andhra Pradesh, India, which included 80 pa?ents who were clinically diagnosed with hyperpigmented skin lesions in all age groups from July 2014 to August 2016. Frequency and percentage sta?s?cs was used to present the results. Results: Out of 80 cases, 34 cases of inflammatory lesions, 23 cases of benign lesions and 23 cases of malignant lesions were reported. Among the post inflammatory lesions the majority were classical Lichen planus. Conclusion: Most common lesion was lichen planus and its variants with highest incidence in females and age group greater than 60 years. Histopathological diagnosis with clinical correla?on aids in effec?ve management of the pa?ents.

Novel ALK-EML4 fusion with prominent mucous and hyaline stroma: Expanding the molecular genetic spectrum of S100 and CD34 positive spindle cell tumor

We report a case of a 49-year-old male patient suffering from an intraspinal tumor in the lumbar vertebra. The neoplasm was composed of mono-morphic spindle cells, arrayed in a patternless pattern in a background of prominent myxoid hyaline stroma with perivascular collagen rings in hyper-cellular regions. Instead, aggregated collagen fibers arranged into nodules and apparent calcium deposition were found in hypo-cellular regions. The tumor cells showed immunopositivity with S100 and CD34, whereas lacked SOX10 expression, which were reminiscent of a group of S100 and CD34 co-expression soft tissue spindle cell lesions having recurrent fusions including RAF1, BRAF, NTRK1/2/3, and RET genes. Interestingly, a novel anaplastic lymphoma kinase (ALK)- echinoderm microtubule-associated protein-like 4 (EML4) gene fusion was revealed. To our best knowledge, it was the first time to identify such gene fusion in the Orientals among this mentioned group, and it expands the molecular genetic spectrum of this specific group. The clinical relevance of this novel fusion requires further investigations.

PENILE NEUROFIBROMA IN A 10-YEAR - OLD CHILD: A RARE CASE STUDY

Neurofibromas of the penis occur uncommonly and their solitary occurrence is even rarer. We report a case of a ten year old child presenting with a solitary neurofibroma located on penis. A provisional clinical diagnosis of penile retention cyst was made and histopathological examination releaved a benign spindle cell lesion and few close differential diagnosis were made, which on application of immunohistochemistry was diagnosed as neurofibroma of penis. Surgical excision of the lesion was done and there was no recurrence after a year of follow up.

The significance of radiotherapy in local treatment of recurrent and metastatic mucinous tubular spindle cell carcinoma of the kidney / 西安交通大学学报(医学版)

【Objective】 To analyze the clinical and pathological characteristics of mucinous tubular and spindle cell carcinoma （MTSCC） in the kidney so as to evaluate the value of radiotherapy in local treatment of refractory MTSCC. 【Methods】 A case of MTSCC with recurrent recurrence and metastasis was reported， and the existing literature on MTSCC was reviewed and analyzed to explore the value of radiotherapy in the treatment of MTSCC. 【Results】 After three operations， postoperative pathology of the patient showed mucinous tubular and spindle cell carcinoma of the kidney. Radiotherapy was performed in the first recurrence area， and long-term follow-up in the tumor bed area showed no recurrence. 【Conclusion】 MTSCC， a rare renal epithelial tumor， has the low-grade malignance in most cases， and rarely recurs and has metastasis. This patient had repeated recurrence and metastasis before surgery， but after tumor bed radiotherapy after the first recurrence no lesion was found， suggesting that radiotherapy plays a certain role in preventing local recurrence. It is necessary to further explore the value of radiotherapy in the treatment of MTSCC.

Recurrence of melanoma in the scar after excised Spitz nevus in a 17-year-old child

Abstract Melanoma in childhood is rare and its diagnosis is more difficult than in adults, as it often presents histologic features overlapping with the Spitz nevus. The authors report the case of a 17-year old boy who was first diagnosed with Spitz nevus, however, the final diagnosis made after the excision of the tumor arising in the scar was changed to melanoma. The case in this present study emphasizes the importance of the differential diagnosis of skin tumors in young patients.

Hemangioma fusocelular en las fosas nasales y los senos etmoidales en un lactante de 4 meses de edad / Spindle cell hemangioma of nasal passage and ethmoidal sinus in a 4-month old infant

El hemangioma fusocelular es una neoplasia vascular benigna infrecuente. Afecta la dermis y la hipodermis de la parte distal de las extremidades; la afectación de la cabeza y el cuello es muy poco frecuente y nunca se informó compromiso de los senos paranasales. Este es el caso de un lactante de 4 meses con obstrucción nasal desde las 2 semanas debido a un tumor en los senos etmoidales que obstruía las fosas nasales. Se diagnosticó hemangioma fusocelular y se extirpó parcialmente el tumor. A los seis meses de seguimiento, se observó una regresión mínima con lesiones residuales. A los 30 meses, se observó que el tumor residual había desaparecido. El hemangioma fusocelular es infrecuente en cabeza y cuello y, a veces, la presentación no es indicativa del diagnóstico. El examen histopatológico ayuda con el diagnóstico diferencial y el tratamiento. La sensibilización sobre el hemangioma fusocelular podría aumentar los casos informados.

Spindle cell hemangioma (SCH) is a benign unusual vascular neoplasm. It does not have gender predilection and can occur at all ages. The disease affects dermis and subcutis of distal extremities predominantly; head and neck involvement is very rare, paranasal sinus involvement has not been reported before. Herein we present a 4-month-old infant with nasal obstruction since two weeks of age due to a mass in ethmoid sinus obliterating the nasal passage. After the histopathological diagnosis of SCH, the tumor was partially resected. In the sixth month follow-up, there was minimal regression of residual lesions. In the imaging studies performed 30 months after the surgery, the residual mass was found to be disappeared. SCH is not frequent in the head and neck, and presentation of some patients may not suggest the diagnosis. Histopathology is important for differential diagnosis and to orientate treatment. Awareness of SCH may increase the reported cases

A case report of mucinous tubular and spindle cell carcinoma of the kidney / 中华泌尿外科杂志

Mucinous tubular and spindle cell carcinoma of the kidney is a rare subtype of renal carcinoma. In July 2019, one case of mucinous tubular and spindle cell carcinoma of the kidney was admitted to our hospital, The laparoscopic partial nephrectomy was performed, and there was no recurrence or metastasis during the follow-up period of 13 months. The disease has no obvious clinical manifestations and its diagnosis depends on pathological and immunohistochemical features. Surgical treatment is the main treatment for this disease, and most patients have a good prognosis.Howerer, the possibility of progression remains in the late stage of the disease.

Spitz nevus and infliximab: association or coincidence?

Abstract Biological therapies, including anti-TNF agents, are important in the treatment of various chronic inflammatory diseases, including psoriasis, rheumatoid arthritis or inflammatory bowel disease. The increased use of these drugs translates into an increasing awareness of its adverse effects, which include malignancy. In this paper, we describe the case of a 28-year-old woman who developed a spitzoid melanocytic tumor after starting infliximab therapy for ulcerative colitis. The evidence for causality between anti-TNF and melanocytic proliferations is still sparse; nonetheless, treatment-associated immunosuppression seems to play a key role in this phenomenon. Therefore, a regular follow-up with a rigorous skin examination is essential in these patients. Noninvasive techniques such as dermoscopy or reflectance confocal microscopy are particularly useful diagnostic tools in these circumstances.

An interesting case of spindle cell sarcoma of elbow

Spindle cell sarcomas are a group of aggressive malignant soft tissue tumors with a diverse clinical presentation. A 32 years old woman presented with a recurrent nerve sheath tumour, involving flexor carpi ulnaris and a portion of ulnar nerve. Wide local excision of the tumour was done creating a 4 cm gap defect in the ulnar nerve. Distal nerve transfer and Guyon’s canal release was done and anterior transposition of ulnar nerve to distal motor branch of ulnar nerve end to side (ETS) supercharge was done preserving motor function to the little and ring finger. Achieving negative surgical margins in primary soft tissue sarcoma is a critical for local disease control. The anatomical and functional compromise that can occur while giving adequate clearance margin for the tumor can be overcome by microsurgical techniques and neuroanastomosis with positive outcomes like preservation of function and better prognosis.

Rhabdomyosarcoma of lip - issues of subtyping, morphology and immunohistochemistry versus molecular studies: a case report with review of literature

Rhabdomyosarcoma (RMS) is a malignant soft tissue tumour occurring most frequently in younger age groups. Study presented a rare case of spindle cell Rhabdomyosarcoma of the upper lip involving the commissure area. In this case report after successful surgical excision, the patient underwent extensive postoperative histopathological studies including special stains and immunohistochemistry. Genotype studies (reverse transcription polymerase chain reaction) were done to help in subtyping and prognostication, and it turned out to be a surprise as it showed positivity for PAX3-FOXO1 t (2;13) translocation which is almost exclusively seen with alveolar RMS. After that he successfully underwent chemotherapy and radiotherapy as it was an aggressive variant and has been disease free for the past 2 years. The author hopes that this case report will highlight the importance of high clinical suspicion in head and neck masses presenting in pediatric age group and to not rely solely on biopsy reports to confirm diagnosis, so that early detection will lead to successful therapy and outcome as exemplified in this case.

Eruptive disseminated Spitz nevi - Case report

Abstract Spitz nevus is a benign melanocytic lesion, which presents in several ways: solitary, agminated, or disseminated. The disseminated variant is uncommon; it may have a rapid evolution (the eruptive form) and be difficult to manage. This report presents the case of a 24-year-old patient with multiple papules on his limbs, which had appeared four years previously. On physical examination, 120 pink and skin-colored papules were seen, which under dermoscopy were observed to be homogeneous, pink vascular lesions. Histopathologic study revealed epithelioid cells arranged in groups or singly in the dermis and dermo-epidermal junction. They were HMB-45 positive in the superficial dermis, and Ki-67 < 1%. Given these findings, a diagnosis of eruptive disseminated Spitz nevi was made.

Histopathological spectrum of spindle cell tumours of gastro-intestinal tract

Background: Spindle cell lesions of gastro-intestinal tract (GIT) are relatively uncommon tumours compared to epithelial tumours. The anatomic location of spindle cell tumour is important, whether the tumour is located in mucosa, submucosa or muscularis propria.Methods: Authors endeavoured to study the histopathological spectrum of spindle cell lesions for a period of one year from January 2018 to December 2018 in our hospital.Results: This was a prospective study of 1 year starting from January 2018 to December 2018. A total of 30 cases of spindle cell lesions of gastrointestinal tract were seen. Out of 30 cases 23 were gastrointestinal stromal tumours (GIST), 2 cases were schwannomas, 2 cases were of leiomyomas, 1 case was fibromatosis, 1 case was inflammatory fibroid polyp, and one case was inflammatory myofibroblast tumour.Conclusion: GISTs are the commonest spindle cell tumours of GIT. Besides GIST, there are other spindle cell tumours which range from benign to malignant, and need to be differentiated from GIST for proper management

Morphological Spectrum Of Malignant Renal Tumours In Different Age Groups - Case Series And Review Of Literature

Renal tumours have acquired a new face in the recent times due to the expanding list of new entities. Renal cell carcinoma are classified based on their architectural features (eg: papillary RCC ), cytoplasmic features (eg: clear cell and chromophobe renal cell carcinomas RCCs), anatomic location of tumours (eg: collecting duct and renal medullary carcinomas), and background in which they arise (eg: acquired cystic disease associated RCCs) , based on molecular changes (eg: MiTfamily translocation carcinomas and succinate dehydrogenase [SDH]–deficient renal carcinomas) or familial predisposition syndromes (eg: hereditary leiomyomatosis and RCC [HLRCC] syndrome–associated RCC). This article provides an insight into the various new entities and difficulties encountered in the diagnosis.

Solitary fibrous tumor of the orbit: Computed tomography and histopathological findings

A solitary fibrous tumor is a rare spindle cell neoplasm originating from the mesenchyme. This type of tumor of the orbit is very uncommon and can be misdiagnosed as a hemangiopericytoma, fibrous histiocytoma, meningioma, or neurofibroma. We report an orbital solitary fibrous tumor in an 18-year-old male, with slow-growing swelling in the right orbital region. An orbital contrast-enhanced computed tomography scan showed heterogeneously enhancing right extraconal inferomedial mass, with no evidence of calcification or bone destruction. The lesion was surgically excised without complications. Based on microscopic and immunohistochemical findings, the mass was finally diagnosed as a solitary fibrous tumor. These tumors should be preoperatively differentiated from other spindle cell tumors of the orbit, and radiological imaging methods are useful in the differential diagnosis but are nonspecific. Therefore, histopathological and immunohistochemical staining features are more useful for the diagnosis of solitary fibrous tumors, especially CD34 staining

Fibrosarcoma of the Oral Cavity: A Case Report

Fibrosarcomas are relatively uncommon malignant tumors arising from fibrous connective tissue and are characterized by increased abnormal proliferation of malignant fibroblast. Fibrosarcoma is capable of local recurrence and metastasis with poor prognosis. Approximately 0.05% of cases are noted in the head and neck region amongst all the cases recorded in the human race. In the present case, we report a case of fibrosarcoma of the mandible in 24 years old female who was presented with small intraoral swelling in the lower anterior vestibule with the involvement of floor of the mouth. Histopathology revealed a proliferation of malignant fibroblast cells arranged in a classical herringbone pattern.