Mucinous tubular and spindle cell carcinoma with a high nuclear grade and micropapillary pattern: A case report

Sakatani, Toru; Okumura, Yoshinaga; Magaribuchi, Tatsuo; Nakano, Yujiro; Shirahase, Toshiaki; Watanabe, Jun; Taki, Yoji; Okigaki, Mitsuhiko; Ikehara, Susumu; Adachi, Yasushi

doi:10.3892/mco.2017.1430

Cited by 10 publications

(14 citation statements)

References 17 publications

(19 reference statements)

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“…The patient died a few months later. In another investigation, Sakatani et al ( 23 ) reported that the CT scan showed para-aortic lymph node metastasis and hepatic metastasis 5 months after radical nephrectomy. The patient received treatment with sunitinib but succumbed to a brain metastasis ( 23 ).…”

Section: Discussionmentioning

confidence: 95%

“…In another investigation, Sakatani et al ( 23 ) reported that the CT scan showed para-aortic lymph node metastasis and hepatic metastasis 5 months after radical nephrectomy. The patient received treatment with sunitinib but succumbed to a brain metastasis ( 23 ). In a study by Shiro et al ( 24 ), distant metastases were revealed in the liver and bone by CT imaging after partial nephrectomy, and the patient, who received molecular targeted therapy and irradiation, succumbed due to tumor progression ( 24 ).…”

Section: Discussionmentioning

confidence: 95%

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Mucinous tubular and spindle cell carcinoma of the kidney: Five case reports and review of the literature

et al. 2020

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Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney is a rare and polymorphic tumor, which has been previously considered to be a low-grade malignancy, predominantly occurring in women. To the best of our knowledge, MTSCC with bladder metastasis has never been reported. The current study presents five adult cases of MTSCC that included three male and two female patients. Among the male cases, two were of advanced stage, one with MTSCC and renal chromophobe cell carcinoma with bladder metastasis and the other with MTSCC with invasion of the renal vein. The other three cases with small masses were at an early stage. All five cases had a good prognosis and were without recurrence after several years of follow-up. A 70-year-old male with intermittent gross hematuria, intermittent renal colic, and groin radiation pain for a year (case 1), was incidentally detected to have a left renal density mass by total abdominal enhanced computed tomography scans. In the other four cases, renal masses were found by B-ultrasound. The patient in case 1 underwent a retroperitoneal laparoscopic radical nephroureterectomy with bladder cuff resection and transurethral resection of the bladder tumor, and received gemcitabine hydrochloride via intravesical instillation therapy plus cisplatin chemotherapy every 3 months. The patient in case 2 underwent an open left radical nephrectomy and renal pedicle lymph node dissection. The other three patients underwent a laparoscopic radical nephrectomy. All five patients had no recurrence or new metastasis in other organs after follow-up. In conclusion, the incidence of MTSCC in men and women is not as disparate as reported in previous publications. The characteristics of the images of the five adult cases in the present study showed a considerable consistency, with only minor differences. The malignancy and prognosis of MTSCC are still controversial, and thus inclusion and review of more cases is required to reach a definite final conclusion. Sunitinib and gemcitabine chemotherapy in combination with cisplatin may be effective for the therapy of MTSCC patients with metastasis, but a larger range of treatments needs to be identified.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

Mucinous tubular and spindle cell carcinoma of the kidney: Five case reports and review of the literature

et al. 2020

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“…On an average of 8 months (range 1 to 19 months) follow-up, 5 (71%) patients developed metastatic disease, while 4 (57%) died of the disease. In 5 cases reported with epithelial high nuclear grade 15 , 18 , 20 , 21 , the mean patient age was 70 years (range 60 to 82 years), with all patients being male. With an average of 18 months (range 4 to 48 months) follow-up, 4 (80%) patients died from metastatic disease.…”

Section: Discussionmentioning

confidence: 99%

“…While most studies in the literature suggest MTSCC to be non-aggressive, there have been sporadic reports of MTSCCs demonstrating high-grade features 13 – 22 and, occasionally, adverse clinical outcome 14 – 17 , 19 – 21 , 23 – 25 . Sarcomatoid transformation is the most well-established form of high grade transformation, with the tumor exhibiting a spindle cell component with marked nuclear pleomorphism, increased mitotic activity, frank tumor necrosis, and expansile growth 13 , 14 , 16 , 17 , 19 .…”

Section: Introductionmentioning

confidence: 99%

Adverse histology, homozygous loss of CDKN2A/B, and complex genomic alterations in locally advanced/metastatic renal mucinous tubular and spindle cell carcinoma

et al. 2021

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Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare subtype of renal cell carcinoma with characteristic histologic features and chromosomal alterations. Although typically indolent, a small subset of cases has been reported to exhibit aggressive clinical behavior. We retrospectively identified 33 patients with MTSCC, consisting of 10 cases of locally advanced / metastatic-MTSCC (pT3 or N1 or M1) and 23 kidney confined-MTSCC (pT1/T2) without disease recurrence or progression. Utilizing a single nucleotide polymorphism array and a targeted next-generation sequencing platform, we examined genome-wide molecular alterations in 24 cases, including 11 available samples from 8 patients with locally advanced / metastatic-MTSCC. Ten patients with locally advanced / metastatic-MTSCC were 8 females (80%) and 2 males (20%). At nephrectomy, 7 of these 10 cases (70%) were pT3 or pN1 while the remaining 3 (30%) were pT1/T2. Eight patients (80%) developed metastases and common sites included lymph node (4, 40%), bone (4, 40%), and retroperitoneum (3, 30%). Four patients died of disease (40%) during follow-up. Locally advanced / metastatic-MTSCCs shared typical MTSCC genomic profiles with loss of chromosomes 1, 4, 6, 8, 9, 13, 14, 15, and 22, while some exhibited additional complex genomic alterations, most frequently a relative gain of 1q (7/8). Homozygous loss of CDKN2A/B was observed in 3 (38%) locally advanced / metastatic-MTSCCs. Tumor necrosis, solid nested/sheet pattern, irregular trabecular/single-file infiltration in a desmoplastic stroma, lymphovascular space invasion, and increased mitotic activity were associated with locally advanced / metastatic-MTSCCs (all p < 0.05). Our findings reveal that MTSCCs with aggressive clinical behavior have progressed through clonal evolution; CDKN2A/B deletion and additional complex genomic abnormalities may contribute to this process. Recognizing the morphologic presentation of high grade MTSCC and evaluating adverse histologic features seen in these tumors can help establish a definitive diagnosis and stratify patients for treatment and prognostication.

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“…To our knowledge, around 20 cases of recurrence after nephrectomy in RMTSCC have been reported. Among them, the detailed clinical course and prognosis after nephrectomy have been reported in 10 cases, which are summarized in Table . The median patient age was 67.5 (range 32–82) years.…”

Section: Discussionmentioning

confidence: 99%

Case of renal mucinous tubular and spindle cell carcinoma with high nuclear grade

et al. 2019

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Abbreviations & Acronyms AMACR = a-methyl acyl CoA racemase CD = cluster of differentiation CK = cytokeratin CT = computed tomography NA = not available OS = overall survival PET = positron emission tomography RCC = renal cell carcinoma RFS = recurrence-free survival RMTSCC = renal mucinous tubular and spindle cell carcinoma RT = radiation therapy WHO = World Health Introduction: Renal mucinous tubular and spindle cell carcinoma is a rare subtype of renal cell carcinoma newly added to the World Health Organization classification in 2004.Although it has been considered as a tumor with good prognosis, aggressive cases have recently been reported. Case presentation: A 52-year-old man was diagnosed as having left renal cell carcinoma. Open radical left nephrectomy and left-sided pelvic lymph nodes dissection were performed. Pathological diagnosis revealed a renal mucinous tubular and spindle cell carcinoma with high nuclear grade and extra-regional lymph nodes metastasis classified as pT3aN0M1. After nephrectomy, metastasis at second lumbar vertebra and lymph nodes recurrence were occurred. Conclusion: This tumor with high nuclear grade may be potentially aggressive and carries a poor prognosis.Some tumors of RMTSCC with high nuclear grade may have an aggressive course with poor prognosis. When diagnosing RMTSCC, clinicians should carefully observe the nuclear grade of the neoplastic cells and the area occupied by these cells with high nuclear grade.

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Mucinous tubular and spindle cell carcinoma with a high nuclear grade and micropapillary pattern: A case report

Cited by 10 publications

References 17 publications

Mucinous tubular and spindle cell carcinoma of the kidney: Five case reports and review of the literature

Mucinous tubular and spindle cell carcinoma of the kidney: Five case reports and review of the literature

Adverse histology, homozygous loss of CDKN2A/B, and complex genomic alterations in locally advanced/metastatic renal mucinous tubular and spindle cell carcinoma

Case of renal mucinous tubular and spindle cell carcinoma with high nuclear grade

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