Miura Koujin, Adachi Yasushi, Shirahase Toshiaki, Nagashima Yoji, Suemune Kazuki, Sakaida Noriko, Nakano Yorika, Sakai Yasuhiro, Shimizu Shigeki, Ikehara Susumu
Resident, Toyooka Hospital, Toyooka, Hyogo, Japan.
Department of Diagnostic Pathology, Toyooka Hospital, Toyooka, Hyogo, Japan.
J Surg Case Rep. 2020 Feb 21;2020(2):rjaa014. doi: 10.1093/jscr/rjaa014. eCollection 2020 Feb.
Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare renal cell carcinoma that initially presents as low-grade renal cell carcinoma. However, cases of MTSCC with high-grade histology and poor prognosis have been reported. Here, we report a case of MTSCC with high-grade histological features and metastasis. A 77-year-old woman consulted a hospital following frequent and painful micturition. Computed tomography scan revealed a tumor of the left kidney. First, chemotherapy was performed, with no effects. Therefore, nephrectomy was subsequently performed. Histologically, the tumor showed the features of MTSCC with sarcomatoid component. Metastasis of the tumor into the lymph node was also observed. Although adjuvant chemotherapy was performed after nephrectomy, metastasis to the lungs and bone and local recurrence was observed. The patient is still alive 2 years after nephrectomy with metastasis and recurrence of the tumor. High-grade MTSCC shows a relatively poor prognosis, specifically MTSCC with metastasis upon nephrectomy.
黏液性小管状和梭形细胞癌（MTSCC）是一种罕见的肾细胞癌，最初表现为低级别肾细胞癌。然而，已有报道称存在具有高级别组织学特征和预后不良的MTSCC病例。在此，我们报告一例具有高级别组织学特征和转移的MTSCC病例。一名77岁女性因尿频和尿痛到医院就诊。计算机断层扫描显示左肾有一个肿瘤。首先进行了化疗，但无效。因此，随后进行了肾切除术。组织学上，肿瘤表现出具有肉瘤样成分的MTSCC特征。还观察到肿瘤转移至淋巴结。尽管肾切除术后进行了辅助化疗，但仍观察到肿瘤转移至肺和骨以及局部复发。肾切除术后2年，患者仍存活，但肿瘤出现转移和复发。高级别MTSCC预后相对较差，特别是肾切除时伴有转移的MTSCC。
