A case report of an unusual kidney tumor: Mucinous tubular and spindle cell carcinoma

Tanja  Lakić; Aleksandra Ilić; Mirjana Živojinov; Jelena Ilić Sabo; Dimitrije Jeremić; Dragan Grbić

doi:10.2298/VSP190523108L

Tanja Lakić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Aleksandra Ilić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Mirjana Živojinov University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Jelena Ilić Sabo University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Dimitrije Jeremić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Dragan Grbić Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia

DOI: https://doi.org/10.2298/VSP190523108L

Ključne reči: bubreg, neoplazme, karcinom bubrežnih ćelija, karcinom bubrežnih ćelijaadenokarcinom, mucinozni, dijagnoza, nefrektomija, lečenje, ishod

Sažetak

Uvod. Mucinozni tubularni vretenastoćelijski karcinom bubrega (MTSCC) je redak i nedavno opisan podtip karcinoma bubrežnih ćelija (RCC). Kao što mu ime kaže, tumor se sastoji od tri morfološki različite strukture: tubuli sačinjeni od kubičnih ćelija, zatim vretenaste ćelije i ekstracelularna sluz. Prikaz bolesnika. U radu je prikazana 59-godišnja bolesnica koja je primljena u Urgentni centar Kliničkog centra Vojvodine zbog povreda nastalih u saobraćajnoj nesreći. Nakon dijagnostičkih procedura, kompjuterskom tomografijom (CT) otkrivena je asimptomatska velika cista gornjeg pola levog bubrega kao uzgredni nalaz. Četiri meseca kasnije, nakon oporavka od traumatskih povreda, kontrolnim CT pregledom potvrđen je dobro ograničen tumor, promera 90 mm, ograničen na bubreg, zbog čega je izvršena radikalna nefrektomija. Histopatološkom analizom ustanovljeno je da se radi o nekrotičnoj tumorskoj masi sastavljenoj od tubula sagrađenih od kubičnih ćelija i snopova vretenastih ćelija, razdvojenih bledim mucinoznim materijalom u nekim područjima, dok su ostali delovi tumora bili bez produkcije mucina i prisustva atipije. Zaključak. MTSCC je varijanta papilarnog RCC, pa se obično pogrešno dijagnostikuje kao papilarni RCC sa sarkomatoidnom diferencijacijom. Zbog istog imunoprofila sa papilarnim RCC, histomorfologija predstavlja zlatni standard za postavljanje dijagnoze. MTSCC je tumor sa, generalno povoljnom prognozom i kompletna hirurška ekscizija je adekvatan tretman lečenja, iako su opisani pojedinačni slučajevi metastatske bolesti. Kod ove bolesnice nije bilo znakova bolesti godinu dana nakon operacije.

Reference

Eble JN, Sauter G, Epstein JI, Sesterhenn IA. World Health Or-ganization Classification of Tumours Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. Lyon: IARC Press; 2004.

Chander B, Bharti R, Preet K, Deb P. Mucinous tubular and spindle cell carcinoma of kidney: A case report of an unusual tumor. J Can Res Ther 2015; 11(3): 659.

Dhillon J, Amin MB, Selbs E, Turi GK, Paner GP, Reuter VE. Mucinous tubular and spindle cell carcinoma of the kidney with sarcomatoid change. Am J Surg Pathol 2009; 33(1): 44–9.

Kuroda N, Hes O, Michal M, Nemcova J, Gal V, Yamaguchi T, et al. Mucinous tubular and spindle cell carcinoma with Fuhrman nuclear grade 3: a histological, immunohistochemical, ultra-structural and FISH study. Histol Histopathol 2008; 23(12): 1517‒235.

Zhao M, He X, Teng X. Mucinous tubular and spindle cell renal cell carcinoma: a review of clinicopathologic aspects. Diagn Pathol 2015; 1: 168.

Lima MS, Barros-Silva GE, Pereira RA, Ravinal RC, Tucci S Jr, Costa RS, et al. The imaging and pathological features of a mu-cinous tubular and spindle cell carcinoma of the kidney: A case report. World J Surg Oncol 2013; 11: 34.

Fine SW, Argani P, DeMarzo AM, Delahunt B, Sebo TJ, Reuter VE, et al. Expanding the histologic spectrum of mucinous tubular and spindle cell carcinoma of the kidney. Am J Surg Pathol 2006; 30(12): 1554–60.

Kuroda N, Tamura M, Hes O, Michal M, Kawada C, Shuin T, et al. Renal cell carcinoma with extensive clear cell change shar-ing characteristics of mucinous tubular and spindle cell carci-noma and papillary renal cell carcinoma. Pathol Int 2009; 59(9): 687–8.

Shen SS, Ro JY, Tamboli P, Truong LD, Zhai Q, Jung SJ, et al. Mucinous tubular and spindle cell carcinoma of kidney is probably a variant of papillary renal cell carcinoma with spin-dle cell features. Ann Diagn Pathol 2007; 11(1): 13‒21.

Paner GP, Srigley JR, Radhakrishnan A, Cohen C, Skinnider BF, Tickoo SK, et al. Immunohistochemical analysis of mucinous tubular and spindle cell carcinoma and papillary renal cell car-cinoma of the kidney-significant immunophenotypic overlap warrants diagnostic caution. Am J Surg Pathol 2006; 30(1): 13‒9.

Ferlicot S, Allory Y, Compérat E, Mege-Lechevalier F, Dimet S, Sibony M, et al. Mucinous tubular and spindle cell carcinoma: A report of 15 cases and a review of the literature. Virchows Arch 2005; 447(6): 978‒83.

Kenney PA, Vikram R, Prasad SR, Tamboli P, Matin SF, Wood CG, et al. Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney: a detailed study of radiological, pathological and clinical outcomes. BJU Int 2015; 116(1): 85‒92.

Levakov I, Vojinov S, Marusic G, Popov M, Levakov O, Popov M, et al. Safety profile of temsirolimus in patients with metastatic renal cell carcinoma. J BUON 2016; 21(6): 1442‒8.

Ursani NA, Robertson AR, Schieman SM, Bainbridge T, Srigley JR. Mucinous tubular and spindle cell carcinoma of kidney without sarcomatoid change showing metastases to liver and retroperitoneal lymph node. Hum Pathol 2011; 42(3): 444–8.

Thway K, du Parcq J, Larkin JM, Fisher C, Livni N. Metastatic renal mucinous tubular and spindle cell carcinoma. Atypical behavior of a rare, morphologically bland tumor. Ann Diagn Pathol 2012; 16(5): 407–10.

Prikaz bolesnika sa retkim tumorom bubrega – mucinozni tubularni vretenastoćelijski karcinom

Sažetak

Reference