Mucinous tubular and spindle cell carcinoma with a high nuclear grade and micropapillary pattern: A case report

Sakatani,Toru; Okumura,Yoshinaga; Kuroda,Naoto; Magaribuchi,Toshihiro; Nakano,Yorika; Shirahase,Toshiaki; Watanabe,Jun; Taki,Yoji; Okigaki,Mitsuhiko; Ikehara,Susumu; Adachi,Yasushi

doi:10.3892/mco.2017.1430

Mucinous tubular and spindle cell carcinoma with a high nuclear grade and micropapillary pattern: A case report

Authors:
- Toru Sakatani
- Yoshinaga Okumura
- Naoto Kuroda
- Toshihiro Magaribuchi
- Yorika Nakano
- Toshiaki Shirahase
- Jun Watanabe
- Yoji Taki
- Mitsuhiko Okigaki
- Susumu Ikehara
- Yasushi Adachi
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Affiliations: Department of Urology, Toyooka Hospital, Toyooka, Hyogo 668‑8501, Japan, Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi 780‑8562, Japan, Department of Histopathology and Cytology, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602‑8026, Japan, Department of Internal Medicine, Otokoyama Hospital, Yawata, Kyoto 614‑8366, Japan, Professor Emeritus, Kansai Medical University, Hirakata, Osaka 573‑1010, Japan, Department of Diagnostic Pathology, Toyooka Hospital, Toyooka, Hyogo 668‑8501, Japan
Published online on: September 29, 2017 https://doi.org/10.3892/mco.2017.1430
Pages: 976-980
Copyright: © Sakatani et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Mucinous tubular and spindle cell carcinoma (MTSCC) is rare in renal cell carcinoma (RCC) and usually demonstrates a low nuclear grade and a better prognosis compared with other RCCs. The authors present a case report of MTSCC containing an area of Fuhrman nuclear grade 3, in addition to an area with a micropapillary pattern. An 82‑year‑old man consulted a hospital due to macrohematuria, and a tumor in the right kidney was detected. The tumor was resected and histologically examined. The tumor consisted of various growth patterns: Elongated tubular structure, a papillary structure containing a micropapillary pattern and solid pattern with spindle cells. The tumor cells demonstrated Fuhrman nuclear grades 2 and 3. Invasion into the lymph vessel and metastasis into the regional lymph node were observed. Thus, the tumor was diagnosed as a high grade MTSCC. Five months following resection, a computed tomography scan suggested metastasis of the tumor into the para‑aortic lymph nodes and liver, and the patient succumbed to brain metastasis. When MTSCC of kidney is observed, careful histological observation is important to avoid missing a high nuclear grade area.

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