title: Clear cell changes in mucinous tubular and spindle cell carcinoma: cytoplasmic pallor/clearing within tubules, vacuoles or hybrid conventional clear cell carcinoma of kidney?
abstract: Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare and recently recognized subtype of renal cell carcinoma (RCC). Apart from the classic morphology comprising conventional three components, there exist a large number of non-classic morphological variants of MTSCC, which make it necessity to differentiate from other RCC. Herein, we report two non-classic morphological variants of MTSCC. Case 1, a 85 years old man, showed numerous vacuoles among inherent components and cytoplasmic pallor/clearing within tubules mimicking conventional clear cell RCC with a 8.5 years follow-up, while Case 2 indicated a "mucin-poor" MTSCC associated with simultaneous conventional clear cell RCC at her age of 73 years. Until now Case 1 carries the longest disease-free survival reported in literature since MTSCC was defined and ranks the oldest since reported in literature, while Case 2 is the first report of "mucin-poor" MTSCC associated with simultaneous conventional clear cell RCC. Now, since no biomarkers or imagining tools but pathological examination can confirm the diagnosis of MTSCC, the management is always following the guideline of RCC in clinical practice. Generally, most reports consider it as a good prognosis disease, but sarcomatoid variant, even classic subtype can progress rapidly to life-threatening disease.
authors.affiliation: Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 200025, China.
authors.forename: Wanli
authors.initials: W
authors.lastname: Cao
authors.affiliation: Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 200025, China.
authors.forename: Baoxing
authors.initials: B
authors.lastname: Huang
authors.affiliation: Department of Pathology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 200025, China.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Fei
authors.affiliation: Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 200025, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 200025, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Dai
authors.affiliation: Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 200025, China.
authors.forename: Wenlong
authors.initials: W
authors.lastname: Zhou
authors.affiliation: Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 200025, China.
authors.forename: Zhaoping
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 200025, China.
authors.forename: Hengchuan
authors.initials: H
authors.lastname: Su
authors.affiliation: Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 200025, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Cheng
authors.affiliation: Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 200025, China.
authors.forename: Fukang
authors.initials: F
authors.lastname: Sun
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000473:pathology; D002288:Adenocarcinoma, Mucinous / Q000473:pathology; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D003593:Cytoplasm / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D009077:Mucins
keywords: Mucinous tubular and spindle cell carcinoma of the kidney; clear cell carcinoma; prognosis; therapy