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INTRODUCTION AND IMPORTANCE: Mucinous Tubular and Spindle Cell Carcinoma (MTSCC) of the kidney is a rare variant, first classified by WHO in 2004 classification of RCC. MSCC has distinct morphology and immunohistochemistry unlike challenging previous renal tumor classifications. Despite its rarity, MTSCC diagnosis is important due to its unique characteristics. CASE PRESENTATION: We present a 56-year-old female with a decade-long history of right-side abdominal pain and swelling. Physical examination revealed a 15*10 cm mass on the right flank. Imaging indicated a heterogeneously enhancing right renal mass, diagnosed as localized right Renal Cell Carcinoma (RCC). A radical nephrectomy was performed, and the biopsy confirmed MTSCC. The patient was discharged on the 6th post-op day, with no adjuvant treatment due to localized tumors. CLINICAL DISCUSSION: MTSCC, constituting <1 % of RCC, primarily affects females (1:3-4) with an indolent course. Radical nephrectomy is the preferred treatment, offering a favorable prognosis. However, a small percentage may experience metastasis, necessitating mandatory follow-up. CONCLUSION: MTSCC of the kidney is a rare RCC variant with an excellent prognosis. Surgical excision, specifically radical nephrectomy, is the mainstay of treatment. Adjuvant therapy may not be required for localized tumors. Postoperative follow-up is crucial, despite the rare risk of metastasis reported in some cases.
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Synchronous pancreatic neuroendocrine tumors and renal cell cancer are extremely rare. Von-Hipple-Landau syndrome is a major association. A 43-year-old male patient with left upper quadrant pain and significant weight loss was diagnosed with a synchronous pancreatic tail neuroendocrine tumor with solitary splenic metastasis and a clear-cell renal cell carcinoma of the left kidney. Sonography and a computed tomography scan of the abdomen showed a complex exophytic left renal mass and a necrotic lesion limited to the spleen. Although not apparent on preoperative imaging, distal pancreatic mass was also discovered intraoperatively. Subsequently, left radical nephrectomy, splenectomy, and distal pancreatectomy were performed, and the synchronous primaries and splenic metastasis were confirmed histopathologically. This case is unique in that it demonstrates multiple extremely rare events occurring simultaneously, namely pancreatic and kidney primaries, as well as solitary splenic metastasis.