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@#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.
Subject(s)
Kidney Neoplasms , Immunohistochemistry , Pathology, SurgicalABSTRACT
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.
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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.
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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.
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Objective There are few clinical cases of mucinous tubluar and spindle cell carcin oma (MTSCC).The article aimed to explore its clinical features and prognosis in order to raise awareness of the disease . Methods A retrospective analysis was conducted on the clinical data of 12 patients with renal MTSCC from June 2009 to June 2017.All the patients were treated with unilater-al radical nephrectomy or enucleation .After discharge, the patients were regularly reviewed or followed up by telephone . Results Of the 12 patients with renal MTSCC, 8 were female, 4 were male, 10 were atypical and 1 was atypical (oligominal tubule), all of them were treated with surgery, one of them lost contact, and the remaining 11 patients had good prognosis. Conclusion Renal MTSCC is a rare form of renal cancer, which is more common in females.The imaging data show that there is no blood supply for renal tumors . Renal MTSCC has a good prognosis , with no recurrence or metastasis, and surgical resection is still the preferred treatment .All the 12 patients with renal MTSCC are in early pathological stage with good prognosis , indicating that renal MTSCC may be a low -grade malig-nancy with good prognosis .
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Mucinous tubular and spindle cell carcinoma ( MTSCC) is a rare and low-grade of renal epithelial tumors ,which is more common in adult female .The pathological characteristics of the MTSCC shows that the tumor cells are floating in the mucus matrix with tubular and solid beam-like arrangement .The MTSCC can be asymptomatic or present non-specific symptoms , have good prognosis in most patients,while a small number of it can recurrence ,metastasis,and even death.The purpose of this article is to review the re-search progression of clinicopathological features , treatment and prognosis of MTSCC .
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Mucinous tubular and spindle cell carcinoma ( MTSCC) is a rare and low-grade of renal epithelial tumors ,which is more common in adult female .The pathological characteristics of the MTSCC shows that the tumor cells are floating in the mucus matrix with tubular and solid beam-like arrangement .The MTSCC can be asymptomatic or present non-specific symptoms , have good prognosis in most patients,while a small number of it can recurrence ,metastasis,and even death.The purpose of this article is to review the re-search progression of clinicopathological features , treatment and prognosis of MTSCC .
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Objective To improve the diagnosis and treatment of renal mucinous spindle cell carcinoma,and the knowledge of the type of kidney cancer.Methods The clinical date of 1 case of renal MTSCCa was reported.The case of patient was a 38-year-old women with abdominal discomfort and hematuresis.Ultrasound tip:the upper pole of the right kidney mixed echo placeholder,tumor and the surrounding is obvious blood flow signal.CT revealed a low density shadow in the upper pole of the right kidney,involving the right renal vein,partial filling defect,visible in the inferior vena cava are visible low density shadow,uneven enhancement after the reinforcement,and has delayed reinforcement.MRI shows:the upper pole of the right kidney huge soft tissue mass,T1WI shows low signal,T2WI show slightly higher signal,uneven enhancement and have delayed reinforcement.Preoperative diagnosis:right renal clear cell carcinoma with right renal vein and inferior vena cava tumor emboli.With kidney cancer radical resection and take out inferior vena cava tumor emboli,in the operation right kidney tumor,about 10 cm × 20 cm,right renal vein and inferior vena cava tumor emboli in formation,inferior vena cava tumor emboli within about 8 cm,the clinical and pathologic feature was analyzed and discussed with litcrature review.Results The operation smoothly.Pathological findings suggested higher grade mucinous tubular and spindle cell carcinoma;microscopically a large number of ingredients mixed bundle arrangement of spindle cells,nuclear fission as easy to see.Immunohistochemical staining:Vimentin ±,Syn +,NSE +,CD99 +,Ki-67 + 70％.According to the 2010 AJCC for kidney cancer TNM staging,the pathological pT3c N0M0.According to the Robson stage]].The patient reserved interferonα-2a associate with interleukin-2 theraph after a month.During treatment in patients with fever and other flu symptoms,weekly review of routine blood,liver and kidney function has no obvious abnormalities.The patient died of pulmonary embolism,liver,lung multiple metastases two months later.Conclusions Renal mucinous tubular and spindle cell carcinoma is a rare cell types in the kidney pathological classification,women in high incidence,higher pathological types,worse prognosis.
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Objective To investigate the imaging characteristics of mucinous tubular and spindle cell carcinoma of the kindey (MTSCC-K).Methods Five cases of pathologically confirmed MTSCC-K were analyzed retrospectively.All patients underwent CT scanning,and 4 cases underwent conventional MR and diffusion weighted imaging (DWI) scanning.MR enhancement ratio for the tumor was calculated according to MR signal intensity of pre-and post-contrast in tumor and apparent diffusion coefficient (ADC) values of tumor and normal renal cortical.Results Two case located in the right kindey,and 3 cases located in the left kindey.The maximum diameter of lesions ranged from 3.2 cm to 7.1 cm.Five cases showed nearly round shape with clear borderline.Pseudocapsule was found in 4 cases,3 cases had necrosis and cystic,and 1 case had calcification.There were no hemorrhage,fat and invasion of adjacent tissue.Isodensity or hypodense tumors were found on plain CT.Isointense or hyperintense tumors were found on plain T1WI,while isointense or mixed-signal tumors were found on plain T2WI.Slightly homogeneous or heterogeneous enhancement was observed on dynamic enhanced CT or MR,and the solid component of tumors showed hyperintense on DWI and hypointense on ADC.The mean CT value of tumor at the plain,cortical and nephrographic phase was 32.6 HU,46.5 HU and 66.5 HU,respectively.The mean ADC value of tumor and normal renal cortical was 1.23 × 10-3 mm2/s and 2.31 × 10-3 mm2/s,respectively.The mean MR percentage of enhancement value of tumor was 32.7％ and 104.9％,respectively.Conclusions The imaging characteristics of MTSCC-K include nearly round shape,pseudocapsule,clear borderline,necrosis,cystic and calcification.There is no invasion of adjacent tissue and seldom malignant appearances.Isodensity or hypodense can be observed on plain CT,isointense or hyperintense on plain T1WI,and a mild continuously enhancement on dynamic enhanced scanning.
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Background: Mucinous tubular and spindle carcinoma (MTSCC) of kidney is a rare, low-grade polymorphic tumor. Recent studies have described a wide morphology spectrum of this tumor. Aim: To report the clinico-pathologic features of six cases of MTSCC of kidney. Materials and Methods: Six cases of MTSCC of kidney were studied and literature was reviewed. Immunohistochemistry was done by Envision method. Results: The age of the patients ranged from 44 to 84 years (mean 58.5 years). Four patients were males and two were females. The tumor was located in the left kidney in four cases and in the right kidney in two cases. The tumor size ranged from 4.5 to 15 cm (mean 6.4 cm). All tumors exhibited an admixture of tubules, spindle cells, and mucinous stroma in variable proportions. Tubules were predominant in five cases and spindle cells in one case. Psammomatous calcifications, papillations, and necrosis were seen in two cases. Collections of foamy histiocytes were noted in four cases. Cytoplasmic vacuoles and osseous metaplasia were seen in one case each. All cases were Fuhrman's nuclear grade II. Five cases were of stage pT1, and one was pT3. All cases stained positive for alcian blue at pH 2.5. Immunohistochemical stain CK7 was positive in all cases and CD10 was positive in 1/1 case. All patients were alive and well at follow-up of 12-59 months (mean 33.5 months). No metastases were detected. Conclusions: We report six cases of MTSCC of kidney, a rare distinct variant of RCC, with a favorable prognosis. A male predominance was seen in our cases. MTSCC shares histologic and immunohistochemical overlap with papillary renal cell carcinoma (PRCC) and cytogenetic analysis should be performed in difficult cases to avoid a misdiagnosis.
Subject(s)
Adult , Aged , Aged, 80 and over , Carcinoma/diagnosis , Carcinoma/epidemiology , Carcinoma/immunology , Carcinoma/pathology , Carcinoma/surgery , Carcinoma, Renal Cell/diagnosis , Carcinoma, Renal Cell/epidemiology , Carcinoma, Renal Cell/pathology , Carcinoma, Renal Cell/surgery , Female , Humans , Keratin-7/diagnosis , Kidney Neoplasms/diagnosis , Kidney Neoplasms/epidemiology , Kidney Neoplasms/immunology , Kidney Neoplasms/pathology , Kidney Neoplasms/surgery , Male , Nephrectomy/methods , PrognosisABSTRACT
Objective To explore the clinical features, treatment and prognosis of mucinous tubular and spindle cell carcinoma of the kidney. Methods Patient 1, a 42-year-old woman presented with space-occupying lesion of the lower pole of the left kidney with no symptoms in physical examination for 1 week. CT revealed a low-enhanced tumor located in the lower pole of the left kidney in cT1b N0M0. Radical left nephrectomy was performed. Patient 2, a 76-year-old woman presented with space-occupying lesion of the middle of the left kidney with no symptoms in physical examination for 10 d. CT revealed a low-enhanced tumor located in the middle of the left kidney in cT1b N0 M0. Laparoscopic radical left nephrectomy was performed. The patient received adjuvant treatment with IL-2 and interferon-α 3 months after nephrectomy. Patient 3, a 50-year-old woman presented with lumbago for 3 months. CT revealed a low-enhanced tumor located in the right kidney in cT2 N0 M0. Radical right nephrectomy was performed. The patient received adjuvant treatment with IL-2 and interferon-α 3months after nephrectomy. Patient 4, a 60-year-old woman presented with lumbago and hematuria for 15 d. CT revealed a low-enhanced tumor located in the lower pole of the left kidney in cT1a N0M0.Radical left nephrectomy was performed. Results Histological examination of the tumors showed that they consisted of spindle cells arranged in tubular and trabecular patterns embedded in a myxoid stroma. Pathologic diagnosis of all 4 patients were MTSCCa. There was no evidence of recurrence in all patients for 9- 46 months. Conclusions MTSCCa is a rare low-grade renal cell carcinoma.There is a female predominance. Early surgical excision is the best treatment and the prognosis is relatively good.
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Low grade mucinous tubular and spindle cell carcinoma of kidney was newly established as a distinct renal cell carcinoma in the World Health Organization (WHO) classification of 2004. Until now, less than 60 cases have been reported and the largest series represented approximately 15 patients with this type of tumor. Herein, we report a case of mucinous tubular and spindle cell carcinoma in a 63-year-old male presented with right flank pain which was diagnosed after nephrectomy. Pathologists should consider this diagnosis and its spectrum of histopathologic features in mind to ensure an accurate diagnosis.