OBJECTIVE: To characterize the clinical, radiologic and histologic features of Mucinous Tubular and Spindle Cell Carcinoma (MTSCC), as well as oncologic outcomes.
PATIENTS AND METHODS: This is a single institution retrospective analysis of all MTSCC patients from 2002-2011. Patients were excluded if MTSCC could not be confirmed on pathology re-review (n=4). Clinical characteristics, pathology, imaging, and outcomes were reviewed for the 19 included patients.
RESULTS: Median age at diagnosis was 59 years (range 17-71) with a female predominance (78.9%). On contrast enhanced CT scan, MTSCC enhanced less than the cortex during the corticomedullary phase. Mean tumor attenuation was 36 HU (range 24-48), 67 HU (range 41-133), 89 HU (range 49-152), and 76 HU (range 52-106) in the precontrast, corticomedullary, nephrographic and excretory phases, respectively. Sixteen patients were treated with partial (N=5) or radical nephrectomy (N=11) for pT1(62.5%), pT2(31.3%), and pT3a disease(6.3%). One patient had active surveillance. Of 3 patients(13.0%) managed with energy ablation, there was one recurrence that was treated with salvage surgery. One patient(5.3%) had metastatic disease at diagnosis and died of disease 64.7 months later. A patient with a pT2bN0M0 MTSCC with sarcomatoid dedifferentiation developed bone metastases 9.5 months after diagnosis and was alive at 19.0 months. The remainder were free of recurrence or progression.
CONCLUSION: MTSCC is a rare RCC variant. In this largest series to date, MTSCC presented at a broad range of ages and displayed a female predilection. Imaging and pathologic features of MTSCC display some overlap with papillary RCC. MTSCC is associated with excellent outcomes overall, but is not universally indolent.
Written by:
Kenney PA, Vikram R, Prasad SR, Tamboli P, Matin SF, Wood CG, Karam JA. Are you the author?
Department of Urology, Yale School of Medicine, New Haven, CT.
Reference: BJU Int. 2014 Nov 14. Epub ahead of print.
doi: 10.1111/bju.12992
PubMed Abstract
PMID: 25395040