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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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@#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.
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【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.
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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: To explore the clinicopathological features and prognosis of mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney in order to improve the understanding of the tumor. Methods: The clinical and pathological information of 15 patients with MTSCC in 7 hospitals were retrospectively collected and analyzed from July 2010 to July 2018. The sections were reviewed by two high-seniority pathologists. The EnVision two-step immunohistochemical staining technique was used to detect the expressions of villin, cytokeratin 7 (CK7), epithelial membrane antigen (EMA), alpha-methylacyl-CoA racemase (AMACR), transducin-like enhancer of split 1 (TLE1), hepatocyte nuclear factor-1p (HNF-1p)and kidney specific calcium binding protein (Ksp-cadherin). The fluorescence in situ hybridization (FISH) was used to detect the synovial sarcoma translocation (SYT)-synovial sarcoma X chromosome breakpoint (SSX) fusion gene in the patients with sarcomatoid changes and positive immunohistochemical staining of TLE1. Finally, the prognostic data of all patients and the relevant literature were reviewed. Results: Among 15 patients with MTSCC, seven of the patients were male and the other eight were female, with an average age of 62 years (ranging from 48 to 75 years). The tumors were found by chance in 12 patients during physical examination, and the other 3 patients developed clinical symptoms such as frequent urine pain or hematuria, including 1 patient with a history of renal calculi for 15 years. The cut surface of tumor is firm and grey or yellow. Except for 2 cases, the majority of tumors were well-circumscribed. Microscopically, 1 case showed neoplastic necrosis, 13 cases showed a mixture of mucinous stroma, tubules and spindle cells, 1 case was mainly composed of spindle cells and mucus, and 1 case was mainly composed of tubule and mucus. Some tumors were with obvious clear cytoplasmic changes, and two cases were accompanied by sarcomatoid differentiation. The immunohistochemical results showed that the positive rates of villin, CK7, EMA, AMACR, TLE1, HNF-1 p and Ksp-cadherin were 20.0% (3/15), 80.0% (12/15), 93.3% (14/15), 80.0% (12/15), 20.0% (3/15), 20.0% (3/15), 93.3% (14/15) and 13.3% (2/15), respectively; the result of FISH excluded synovial sarcoma. Eight patients were followed up wihout other treatment after operation. Bone metastasis occurred in half a year after operation in one patient with follow-up information, while no evidence of local recurrence or distant metastases was identified in the other 7 patients until now. Conclusion: A few cases of MTSCC can metastasize and belong to malignant tumors. The positive expressions of AMACR, CK7 and villin in some cases suggests that the tumor has both proximal and distal renal tubular origins. The positive expression of HNF-ip is correlated with the histological characteristics of MTSCC clear cytoplasm.
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Objective To investigate the clinical pathological feature of primary pulmonary sarcomatold carcinoma and to make a further understandine of the disease.Methods Data including clinical manifesation,pathological findings,molecular detection and immunophenotyping with pathologically confirmed primary pulmonary sarcomatold carcinoma was retrospectively analyzed.Results 15 patients with PPSC were identified (13 men and 2 women,age ranged 56-76 years,median age 66 years).The tumor were located in the left lobus superior(8 cases),lobus inferior (6 cases),and the right lobus medius (1 case).The main clinical symptoms was cough,sputum,bloody sputum,chest pain.Among the 13 males,10 had smoking history of more than 30 years,and 2 females had no smoking history.All cases presented with a spheroid solid lung mass.All tumor showed mild enhancement similar to that of the surrounding musculature after contrast enhancement,and inhomogeneous central low-attenuation areas were seen in 15 patients.Pathological pattern:6 cases spindle cell carcinoma,4 cases pleomorphic carcinoma,2 cases giant cells carcinoma,2 cases carcinosarcoma,1 case pulmonary blastoma.The tumors were composed of both carcinomatous and sarcomatous elements.Immunohistochemistry showed that CK was all positive,EMA was positive in 7,VIM was positive in 10 of 15 cases.10 patients were tested for common related genes of lung cancer,4 patients had MET14 jump mutation,EGFR L858R gene mutation occurred in 3 cases,KARS G13D gene mutation in 2 cases,and BRAF V600E mutation in 1 case.All 15 patients underwent lobectomy,13 underwent adjuvant chemotherapy,and 6 underwent local radiotherapy.Postoperative follow-up was 8 to 50 months,3 cases were lost,and 4 cases were survival 3 years after the surgery.Conclusion Pulmonary sarcomatold carcinoma is a rare histologic subtype of non-small cell lung cancer.Compared with other NSCLC,there is no special clinical and imageing characteristics.Its definite diagnosis relies on postoperative pathological analysis and immunohistochemical staining,and PSC needs to be diatinguished from a variely of disease.PPSC is more aggressive and poor prognosis.
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Objective@#To investigate the clinical pathological feature of primary pulmonary sarcomatold carcinoma and to make a further understandine of the disease.@*Methods@#Data including clinical manifesation, pathological findings, molecular detection and immunophenotyping with pathologically confirmed primary pulmonary sarcomatold carcinoma was retrospectively analyzed.@*Results@#15 patients with PPSC were identified(13 men and 2 women, age ranged 56-76 years, median age 66 years). The tumor were located in the left lobus superior(8 cases), lobus inferior(6 cases), and the right lobus medius(1 case). The main clinical symptoms was cough, sputum, bloody sputum, chest pain. Among the 13 males, 10 had smoking history of more than 30 years, and 2 females had no smoking history. All cases presented with a spheroid solid lung mass. All tumor showed mild enhancement similar to that of the surrounding musculature after contrast enhancement, and inhomogeneous central low-attenuation areas were seen in 15 patients. Pathological pattern: 6 cases spindle cell carcinoma, 4 cases pleomorphic carcinoma, 2 cases giant cells carcinoma, 2 cases carcinosarcoma, 1 case pulmonary blastoma. The tumors were composed of both carcinomatous and sarcomatous elements. Immunohistochemistry showed that CK was all positive, EMA was positive in 7, VIM was positive in 10 of 15 cases.10 patients were tested for common related genes of lung cancer, 4 patients had MET14 jump mutation, EGFR L858R gene mutation occurred in 3 cases, KARS G13D gene mutation in 2 cases, and BRAF V600E mutation in 1 case. All 15 patients underwent lobectomy, 13 underwent adjuvant chemotherapy, and 6 underwent local radiotherapy. Postoperative follow-up was 8 to 50 months, 3 cases were lost, and 4 cases were survival 3 years after the surgery.@*Conclusion@#Pulmonary sarcomatold carcinoma is a rare histologic subtype of non-small cell lung cancer. Compared with other NSCLC, there is no special clinical and imageing characteristics. Its definite diagnosis relies on postoperative pathological analysis and immunohistochemical staining, and PSC needs to be diatinguished from a variely of disease. PPSC is more aggressive and poor prognosis.
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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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El carcinosarcoma de laringe es un tumor bifásico raro que representa menos del 1% de todos los tumores malignos de laringe. Debido a su doble naturaleza epitelial y mesenquimal esta neoplasia ha sido denominada de distintas maneras en la literatura, siendo indispensable el estudio mediante inmunohistoquímica para establecer un diagnóstico correcto. Se presentan 2 casos de carcinosarcoma de laringe, confirmados mediante estudio con inmunohistoquímica, ambos tratados mediante laringectomía total. Se elabora una discusión de los principales aspectos clínicos, histopatológicos y terapéuticos de esta infrecuente neoplasia.
The larynx carcinosarcoma is a rare biphasic tumor that represents less than 1% of all malignant tumors of the larynx. Because of its biphasic epithelial and mesenchymal nature this neoplasm has been called in different ways in the literature being indispensable the study by immunohistochemistry to establish a proper diagnosis. We present 2 cases of larynx carcinosarcoma confirmed by immunohistochemical study, both treated with total laryngectomy. A discussion of the main clinical, histopathological and therapeutic aspects of this rare neoplasm is made.
Subject(s)
Humans , Male , Middle Aged , Aged, 80 and over , Carcinosarcoma/surgery , Carcinosarcoma/pathology , Laryngeal Neoplasms/surgery , Laryngeal Neoplasms/pathology , Laryngectomy/methods , Carcinosarcoma/diagnostic imaging , Laryngeal Neoplasms/diagnostic imagingABSTRACT
Spindle cell carcinoma (SpCC) is a rare biphasic tumor of epithelial origin that comprises squamous and sarcomatoid components. The diagnosis may be challenging, particularly when the squamous differentiation is not obvious. SpCC of the tongue has rarely been reported. Here we report a case of SpCC on the right border of the tongue of a 28-year-old male. The diagnosis was based on the correlation of clinical, morphological, and immunohistochemical findings. We describe this rare tumor, present at an unusual location in a young patient to contribute to better understanding and awareness of this rare malignancy.
O carcinoma de células fusiformes (CCF) é um tumor bifásico raro de origem epitelial que compreende componentes escamosos e sarcomatoides. O diagnóstico pode ser desafiador, particularmente quando a diferenciação escamosa não é óbvia. Relatos de CCF em língua são extremamente raros. Aqui é relatado um caso de CCF na borda direita da língua de um homem de 28 anos de idade. O diagnóstico foi baseado na correlação de achados clínicos, morfológicos e imunohistoquímicos. Com a descrição deste caso clínico, em uma localização anatômica incomum e em um paciente jovem, pretende-se contribuir para uma melhor compreensão e conhecimento deste tumor maligno raro.
Subject(s)
Carcinoma , Carcinoma, Squamous Cell , Diagnosis, DifferentialABSTRACT
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 investigate the clinic feature, pathology, therapy and prognosis of the sarcomatoid caricinoma or carcinosarcoma of the larynx.@*Methods@#We reviewed the clinical records of 7 patients with laryngeal carcinosarcoma /sarcomatoid caricinoma who were treated at our hospital between June 1996 and August 2016. All patients were men (mean age, 65.9 years; range, 52 to 94 years). Among 7 patients, 6 had a history of smoking; 2 underwent radiotherapy; and 5 patients who didn′t undergo radiotherapy complained of hoarseness. The glottis was the most frequent site of involvement. Most tumors exhibited a polypold or pedunculated gross morphology. Among the 5 patients who didn′t undergo a radiotherapy, 2 were in stage Ⅰ, 2 in stageⅡ, and 1 in stage Ⅲ. The other 2 cases underwent surgeries and radiotherapy were staged.@*Results@#All 7 patients received surgeries, without lymph node metastasis. All the tumors were pathologically carcinosarcoma/sarcomatoid carcinoma. With immunohistochemistry examination, Vimetin was positive in all tumors, SMA positive in 3 tumors, S-100 positive in 1 tumors, but CD-68, HMB-45 or Myglobin was negative in all tumors. With follows-up from 3 months to 20 years, of 7 patients, 4 survived without recurrent, 1 dead, and 2 lost connection.@*Conclusions@#Both of the carcinosarcoma and the sarcomatoid carcinoma of larynx contain pathologically carcinoma and sarcoma. Surgery is the best choice for laryngeal sarcomatoid carcinoma, and these patients without a undergoing radiotherapy before surgery or these with little sarcoma in tumors show better prognosis.
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An 85‑year‑old male presented with painless bulging lesion over the cornea. Clinical history, diagnostic imaging studies, and histopathologic sections were evaluated. The patient clinically displayed an vascularized conjunctival lesion located at the superior bulbar conjunctiva with extension onto cornea covering 2/3 of his pupillary aperture superiorly. His visual acuity was counting fingers at 4 m. The patient underwent a total excision of the lesion including conjunctival and corneal parts. Histopathologic evaluation revealed spindle cell carcinoma which involves the whole conjunctival squamous epithelium with significant polarity loss, nuclear enlargement with hyperchromasia and pleomorphism, and mitotic activity. Diagnosis of spindle cell carcinoma is challenging because of overlapping histopathological features with other spindle cell tumors. The detailed pathologic examination is very important for the decision of proper treatment.
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Spindle cell carcinoma (SpCC) is referred to as a variant of oral squamous cell carcinoma. It is also known as "sarcomatoid squamous cell carcinoma" because it consists of normal squamous carcinoma cells with spindle-shaped cells that appear similar to a sarcoma. The term, "second primary tumor" (SPT) or "double primary tumor", is proposed for a second tumor that develops independently from the first. SPTs can present as either synchronous or metachronous lesions. Synchronous SPTs are defined as tumors occurring simultaneously or within 6 months after the first tumor. The patient in this case, whose primary tumor was in the tongue, was diagnosed with SpCC with metastases to both neck lymph nodes. This case also exhibited a second primary cancer as a synchronous lesion in the thyroid gland, which is uncommon. All carcinomas, both in the tongue and thyroid gland, were removed surgically, and especially in the tongue, an anterolateral thigh free flap was performed successfully to replace the defect.
Subject(s)
Humans , Carcinoma , Carcinoma, Squamous Cell , Epithelial Cells , Free Tissue Flaps , Lymph Nodes , Neck , Neoplasm Metastasis , Neoplasms, Second Primary , Sarcoma , Thigh , Thyroid Gland , Thyroid Neoplasms , TongueABSTRACT
Spindle cell carcinoma (SpCC) of the lung is extremely rare, with an incidence of less than 0.5% among all lung malignancies. Neuroendocrine tumors are frequently associated with secondary primary malignancies. Here, we report a case of metachronous SpCC that occurred after treatment of a primary carcinoid tumor of the lung. The SpCC mass was successfully removed by lobectomy. In immunohistochemical analyses, the tissues were positive for cytokeratin 7 and vimentin.
Subject(s)
Carcinoid Tumor , Incidence , Keratin-7 , Lung , Neuroendocrine Tumors , VimentinABSTRACT
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.