Chrysikos Dimosthenis, Zagouri Flora, Sergentanis Theodoros N, Goutas Nikolaos, Vlachodimitropoulos Dimitrios, Flessas Ioannis, Theodoropoulos George, Lymperi Maria, Birbas Kostantinos, Zografos George C, Mariolis-Sapsakos Theodoros
1st Department of Propaedeutic Surgery, Hippokratio Hospital, University of Athens, Athens, Greece.
Case Rep Oncol. 2012 May;5(2):347-53. doi: 10.1159/000339802. Epub 2012 Jul 3.
Mucinous tubular and spindle cell carcinoma (MTSC) is a rare and newly described type of renal cell carcinoma (RCC) with relatively indolent behavior. Although there are small series of this clinical entity in the literature, its histogenetic origin or line of differentiation remains unclear.
A 67-year-old woman was hospitalized for flank pain; imaging studies revealed a 6.5-cm mass in the right kidney. She was referred for fine needle aspiration of the lesion, which showed an epithelial tumor with round to oval nuclei associated with strands of metachromatic stromal tissue. Cytopathologic diagnosis was consistent with RCC.
Subsequent right heminephrectomy was performed and the surgical pathology specimen showed an MTSC of the kidney. The patient has done well postoperatively, with 24 months of benign follow-up.
A precise differential diagnosis between MTSC and other renal carcinomas (e.g. papillary RCC with sarcomatoid transformation) is important for predicting patient prognosis. Even though MTSC is a rare cause of renal masses, it should be included in the differential diagnosis, especially because its imaging might be misleading, mimicking other benign renal diseases. Heminephrectomy is the preferred treatment in these subjects.
黏液性小管状和梭形细胞癌（MTSC）是一种罕见的、新描述的肾细胞癌（RCC）类型，其行为相对惰性。尽管文献中有关于这一临床实体的小系列报道，但其组织发生起源或分化谱系仍不清楚。
一名67岁女性因胁腹痛住院；影像学检查显示右肾有一个6.5厘米的肿块。她被转诊进行病变的细针穿刺，穿刺结果显示为上皮性肿瘤，细胞核呈圆形至椭圆形，伴有嗜异色性间质组织条索。细胞病理学诊断与肾细胞癌一致。
随后进行了右半肾切除术，手术病理标本显示为肾黏液性小管状和梭形细胞癌。患者术后情况良好，已进行了24个月的良性随访。
准确鉴别黏液性小管状和梭形细胞癌与其他肾癌（如伴有肉瘤样转化的乳头状肾细胞癌）对于预测患者预后很重要。尽管黏液性小管状和梭形细胞癌是肾肿块的罕见病因，但仍应将其纳入鉴别诊断，尤其是因为其影像学表现可能具有误导性，类似其他良性肾脏疾病。半肾切除术是这些患者的首选治疗方法。
