Mucinous, tubular and spindle cell carcinoma of kidney: report of two cases with pathological differences.

OBJECTIVE: To describe two cases of a rare type of renal tumor , mucinous tubular and spindle cell carcinoma (MTSC), with different pathologic features. METHODS: We present: 1) the case of a 36 year-old woman 24-week pregnant, in whom during an examination for a renal colic we discovered a 5.5 cm tumor in the lower pole of the left kidney. 2) A 71-year-old woman that consulted to her doctor due to loss of weight (5 kg) and anorexia. A 15 x 12 x 9.5 cm tumor was found in her left kidney. RESULTS: Radical nephrectomy was performed in both cases. Microscopic examination showed a myxoid matrix containing a proliferation of tubules and spindle cells, with low-grade atypia. Cells were immunoreactive for CK7, racemase, EMA and vimentin and negative for CD10. Case 1 had some foci of papillary morphology, and was pT1. Case 2 had some nests of clear cells and invaded the sinus fat focally. It was staged as pT3a. In April 2012, the patients are alive without evidence of recurrence or metastasis after 13.5 years (case 1) and 8 months (case 2) of follow up. CONCLUSIONS: MTSC is a rare type of renal carcinoma, which can appear with different clinical, gross and microscopic features. This tumor seems to share some morphological and immunohistochemical similarities with renal papillary carcinoma, and the differential diagnosis is difficult. The vast majority of cases reported had favourable evolution, like our case 1, although a remote possibility of metastasis exists, in cases with sarcomatoid differentiation, but even without it.

Stromal prostatic sarcoma: a rare tumor with rare clinical and imaging presentation.

Adult prostatic stromal sarcoma is a rare malignant tumor. The main presenting symptom is urinary retention secondary to bladder outlet obstruction. Prostatic Specific Antigen level can be normal. Imaging features show a prostate mass with or without pelvic organ invasion depending on the aggressiveness of the tumor. We present a patient with prostatic stromal sarcoma who debuted with urinary obstruction, leukocytosis and neutrophilia, prostate enlargement, and hypodense prostate areas on CT images, simulating prostatitis with abscess formation.

Carcinoma mucinoso, tubular y fusocelular renal. Presentación de dos casos con diferencias anatomopatológicas / Mucinous, Tubular and Spindle Cell Carcinoma of Kidney: Report of Two Cases with Pathological Differences

OBJETIVO: Describir dos casos de un tipo raro de tumor renal, el carcinoma mucinoso tubular y fusocelular (CMTF), con diferentes características anatomopatológicas. MÉTODO: Presentamos. 1) el caso de una mujer de 36 años, gestante de 24 semanas, en la que, durante la exploración de un cólico nefrítico, se descubrió un tumor en el polo inferior del riñón izquierdo, de 5.5 cm, y 2), una mujer de 71 años que consultó a su médico por pérdida de peso (5 kg) y anorexia. Se encontró un tumor de 15 X 12 X 9.5 cm en el riñón izquierdo. RESULTADOS: Se realizó nefrectomía radical en ambos casos. Las características microscópicas nos permitieron clasificarlos como CMTF: se observó sobre una matriz mixoide una proliferación de túbulos y células fusiformes, con atipia de bajo grado. Las células eran inmunorreactivas para CK7, racemasa, EMA y vimentina y negativas para CD10. El caso 1 tenía algunos focos de morfología papilar, y fue pT1. El caso 2 tenía algunos nidos de células claras, e invadía focalmente la grasa del seno. Se clasificó como estadio pT3a. En Abril de 2012, las pacientes están vivas, sin recidiva ni metástasis tras 13.5 años (caso 1) y 8 meses (caso 2) de seguimiento. CONCLUSIONES: El CMTF es un tipo infrecuente de carcinoma renal, que se puede presentar con características clínicas, macro y microscópicas variadas. Este tumor parece compartir algunas similitudes morfológicas e inmunohistoquímicas con el carcinoma papilar renal, siendo difícil el diagnóstico diferencial con este. Aunque la gran mayoría de los casos comunicados presenta una evolución favorable, como nuestro caso 1, existe la posibilidad remota de metástasis, en casos con diferenciación sarcomatoide, pero incluso sin ella

OBJECTIVE: To describe two cases of a rare type of renal tumor, mucinous tubular and spindle cell carcinoma (MTSC), with different pathologic features. METHODS: We present: 1) the case of a 36 year-old woman 24-week pregnant, in whom during an examination for a renal colic we discovered a 5.5 cm tumor in the lower pole of the left kidney. 2) A 71-year-old woman that consulted to her doctor due to loss of weight (5 kg) and anorexia. A 15 X 12 X 9.5 cm tumor was found in her left kidney. RESULTS: Radical nephrectomy was performed in both cases. Microscopic examination showed a myxoid matrix containing a proliferation of tubules and spindle cells, with low-grade atypia. Cells were immunoreactive for CK7, racemase, EMA and vimentin and negative for CD10. Case 1 had some foci of papillary morphology, and was pT1. Case 2 had some nests of clear cells and invaded the sinus fat focally. It was staged as pT3a. In April 2012, the patients are alive without evidence of recurrence or metastasis after 13.5 years (case 1) and 8 months (case 2) of follow up. Conlcuisons: MTSC is a rare type of renal carcinoma, which can appear with different clinical, gross and microscopic features. This tumor seems to share some morphological and immunohistochemical similarities with renal papillary carcinoma, and the differential diagnosis is difficult. The vast majority of cases reported had favourable evolution, like our case 1, although a remote possibility of metastasis exists, in cases with sarcomatoid differentiation, but even without it