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Ling C, Tan R, Li J, Feng J. Mucinous tubular and spindle cell carcinoma of the kidney: a report of seven cases. BMC Cancer 2023; 23:815. [PMID: 37649003 PMCID: PMC10470144 DOI: 10.1186/s12885-023-11252-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/03/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE To further analyse the imaging features and tumour outcomes of mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney. MATERIALS AND METHODS The current study retrospectively reviewed the clinical information of seven patients diagnosed with MTSCC at our institution from January 2011 to March 2023. RESULTS The median age at diagnosis was 52 years (range, 32-66 years) and the majority of patients were female (71.4%). On conventional abdominal ultrasound, the majority of the tumours (5/7) were heterogeneous hypoechoic or slightly hypoechoic. Colour Doppler flow imaging showed blood flow within the tumour in 2 cases and peripheral blood flow signal in 1 case. On non-enhanced CT, all tumours had a spherical or ovoid shape, with an expansile growth mode, and had clear or unclear boundaries with the surrounding renal parenchyma. The tumours were either partially exophytic (n = 4) or parenchymal (n = 3), while no cases of completely exophytic tumour was observed (n = 0). On contrast-enhanced CT, the majority of tumours (5/7) showed a heterogenous pattern of enhancement and the mean tumour diameter was 6.7 ± 4.4 cm (range, 2.1-16.8 cm). All patients underwent partial or radical nephrectomy for pT1a (42.9%), pT1b (28.5%), pT2 (14.3%) or pT3b (14.3%) stage. Among these, 1 patient (14.3%) had a level I tumour thrombus at diagnosis and died of disease 24.5 months later. The remaining patients had no recurrence or metastasis. CONCLUSION MTSCC is not universally indolent, which tends to occur in female patients of a broad range of ages. MTSCC is a hypovascular renal tumour, which is different from clear cell renal cell carcinoma (RCC); however, it is difficult to distinguish MTSCC from other hypovascular RCC subtypes because of the overlap of their imaging characteristics.
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Affiliation(s)
- Chunxiang Ling
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jingwu Road 324, Jinan, 250021, Shandong Provincial, China
| | - Ru Tan
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jingwu Road 324, Jinan, 250021, Shandong Provincial, China
| | - Jiamei Li
- Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jingwu Road 324, Jinan, 250021, Shandong Provincial, China
| | - Jizhen Feng
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jingwu Road 324, Jinan, 250021, Shandong Provincial, China.
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Xu X, Zhong J, Zhou X, Wei Z, Xia Q, Huang P, Shi C, Da J, Tang C, Cheng W, Ge J. Mucinous Tubular and Spindle Cell Carcinoma of the Kidney: A Study of Clinical, Imaging Features and Treatment Outcomes. Front Oncol 2022; 12:865263. [PMID: 35480124 PMCID: PMC9035933 DOI: 10.3389/fonc.2022.865263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To describe the clinical, imaging, pathological features and oncologic outcomes of mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney. Patients and Methods Twenty-two cases of MTSCC were pathologically identified between January 2004 and April 2021 at our institution. The clinical and imaging findings, pathological features, treatment methods and outcomes of the patients were reviewed. Results These cases included 17 women and 5 men, with a median age at diagnosis of 52.5 years. On contrast-enhanced CT, MTSCC was less enhanced than the adjacent renal parenchyma. Tumor attenuation values were 33.3 ± 6.8HU, 44.0 ± 9.1HU, 54.4 ± 13.9HU and 67.1 ± 11.8HU in the non-contrast, corticomedullary, nephrographic and excretory phases of CT, respectively. Contrast-enhanced ultrasonography and MRI also showed hypovascular features of the masses. On MRI, the tumors were isointense on T1-weighted images and slightly hypo- or hyperintense on T2-weighted images. Diffusion-weighted imaging revealed a low apparent diffusion coefficient of the tumor. The patients were managed with laparoscopic partial nephrectomy (n=5), radical nephrectomy (n=16), or robotic-assisted laparoscopic partial nephrectomy (n=1). The median follow-up time was 59.5 months. All the patients were free of local recurrence or distant metastasis. Conclusions MTSCC is generally indolent and has favorable outcomes. The imaging features of MTSCC are generally hypovascular, which is significantly different from clear cell renal cell carcinoma. However, it is still difficult to distinguish MTSCC from other hypovascular renal tumors preoperatively because their imaging features overlap. Further studies are essential to fully characterize the features of this rare RCC variant.
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Affiliation(s)
- Xiaofeng Xu
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Jing Zhong
- Department of Radiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Xiumin Zhou
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhifeng Wei
- Department of Urology, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qiuyuan Xia
- Department of Pathology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Pengfei Huang
- Department of Ultrasound Diagnosis, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Changjie Shi
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Jianping Da
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Chaopeng Tang
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Wen Cheng
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
- *Correspondence: Jingping Ge, ; Wen Cheng,
| | - Jingping Ge
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
- *Correspondence: Jingping Ge, ; Wen Cheng,
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Abstract
An introduction to the expanding modality of contrast-enhanced ultrasound is provided, along with basics on contrast agents and technique. The contrast ultrasound findings of multiple renal tumors are reviewed with examples, including clear cell renal cell carcinoma, papillary renal cell carcinoma, chromophobe renal cell carcinoma, other rare renal cell carcinoma subtypes, oncocytoma, upper tract urothelial carcinoma, lymphoma, and angiomyolipoma, followed also by brief discussions of renal infections and pseudolesions.
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Affiliation(s)
- Kevin G King
- Keck School of Medicine, University of Southern California, Norris Cancer Center, 1500 San Pablo Street, 2nd Floor Imaging, Los Angeles, CA 90033, USA.
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Nathany S, Monappa V. Mucinous Tubular and Spindle Cell Carcinoma: A Review of Histopathology and Clinical and Prognostic Implications. Arch Pathol Lab Med 2019; 144:115-118. [DOI: 10.5858/arpa.2017-0506-rs] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Mucinous tubular and spindle cell carcinomas are rare kidney tumors with generally indolent behavior. As the name suggests, classic histomorphology reveals bland spindle cells, tubules, and mucinous stroma. Uncommon histologic features include mucin-poor stroma, high nuclear grade, cellular pleomorphism, and presence of necrosis. Rare cases can show aggressive growth and distant metastasis. Mucinous tubular and spindle cell carcinoma has characteristic chromosomal abnormalities and the molecular signature remains the same, irrespective of the varied histomorphology.
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Affiliation(s)
- Shrinidhi Nathany
- From the Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Vidya Monappa
- From the Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, India
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Du JH, Zhang L, Liang CZ. Huge mucinous tubular and spindle cell carcinoma of kidney: A rare case report and literature review. Medicine (Baltimore) 2018; 97:e12933. [PMID: 30412103 PMCID: PMC6221687 DOI: 10.1097/md.0000000000012933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
RATIONALE Mucinous tubular and spindle cell carcinoma (MTSCC) is a variant of renal cell carcinoma newly added to the WHO classification in 2004. It is a rare variant of renal cell carcinoma and sometimes it is not easy to distinguish MTSCC from papillary renal cell carcinoma, chromophobe renal cell cancer, etc. The prognosis of MTSCC is favorable after surgical resection. PATIENT CONCERNS A 45-year-old male patient presented with a right renal mass that was detected on ultrasonography incidentally. The computed tomography scan showed a huge homogenous mass with patchy calcification in the central area, and the lesion was slightly enhanced after contrast injection. DIAGNOSES According to postoperative pathology, the patient was diagnosed with MTSCC. INTERVENTIONS The patient underwent an open transabdominal radical resection of right kidney and right retroperitoneal lymph node dissection. OUTCOMES The surgical outcomes were good, and no recurrence or metastasis was observed during the follow-up. LESSONS MTSCC is a rare malignancy of the kidney and the prognosis is usually favorable. Preoperative enhanced CT and MRI can help differentiate MTSCC from other renal tumors, so as to provide a more suitable surgical approach for those who need to retain renal function as much as possible.
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