Fuchizawa Hirotaka, Kijima Toshiki, Takada-Owada Atsuko, Nagashima Yoji, Okazaki Akihito, Yokoyama Megumi, Nishihara Daisaku, Ishida Kazuyuki, Kamai Takao
Department of Urology Dokkyo Medical University Shimotsuga Tochigi Japan.
Department of Diagnostic Pathology Dokkyo Medical University Shimotsuga Tochigi Japan.
IJU Case Rep. 2021 Jun 29;4(5):333-337. doi: 10.1002/iju5.12342. eCollection 2021 Sep.
Mucinous tubular and spindle cell carcinoma is a rare subtype of renal cell carcinoma. Little is known regarding the efficacy of systemic therapy on its metastatic form because of its rarity.
We present the case of a patient with metastatic mucinous tubular and spindle cell carcinoma who achieved durable complete remission of multiple osseous metastases after undergoing cytoreductive nephrectomy followed by combination immunotherapy (ipilimumab plus nivolumab). Immunohistochemical analyses of the primary tumor revealed the presence of the tumor-infiltrating immune cells, including activated CD8 T cells and PD-L1 expression, suggesting an immunologically hot tumor.
Combination immunotherapy was a viable treatment option for this disease. Immunohistochemical analyses of the tumor-infiltrating immune cells predicted the efficacy of immune checkpoint inhibitors against rare renal cancers.
黏液性小管状和梭形细胞癌是肾细胞癌的一种罕见亚型。由于其罕见性，关于全身治疗对其转移形式的疗效知之甚少。
我们报告一例转移性黏液性小管状和梭形细胞癌患者，该患者在接受减瘤性肾切除术后联合免疫治疗（伊匹单抗加纳武单抗），多个骨转移灶实现了持久的完全缓解。对原发肿瘤的免疫组织化学分析显示存在肿瘤浸润免疫细胞，包括活化的CD8 T细胞和PD-L1表达，提示为免疫原性高的肿瘤。
联合免疫治疗是该疾病的一种可行治疗选择。对肿瘤浸润免疫细胞的免疫组织化学分析可预测免疫检查点抑制剂对罕见肾癌的疗效。
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