The underlying mechanisms of an association of MTSCC with end-stage renal disease (ESRD) are unknown.
Although MTSCC is considered a relatively indolent tumour, it can metastasise even years after successful primary surgical treatment and it may be associated with end-stage renal disease.
Abbreviations CT: Computed tomography ESRD: End-stage renal disease MRI: Magnetic resonance imaging MTSCC: Mucinous tubular and spindle cell carcinoma RCC: Renal cell carcinoma WHO: World Health Organization.
Caption: Figure 2: Histologic photos of the mucin-poor MTSCC from the biopsy of the metastatic lesion (a and b) and from the initial right kidney tumour specimen (c and d) showing a renal cell tumour with spindle cell component, as well as tubular and papillary parts without any clear cells.
Several studies on large cohorts of patients with renal tumors registered MTSCC rates ranging between 0.8 % and 1.8 % of the cases included [15-17].
MTSCC is obviously more frequent in females, with men versus women ratio of 1:4 [6, 20].
The classic histopathologic pattern of MTSCC comprises three main elements: (i) cuboidal cells forming closely arranged tubules, (ii) a mucinous stroma and (iii) spindle cell areas [3, 18, 23].
Even though most of the MTSCC are low grade tumors with indolent behavior, there were reported cases with high-grade aspect, that exhibit high cyto-nuclear pleomorphism and proliferative index [25, 26].
The immunoprofile of MTSCC has been deeply studied, showing a great deal of variability.
Our case illustrated a typical patient with MTSCC, according to the female predominance, the average age at diagnosis and the clinically silent behavior of the tumor.
The pattern of expression of kidney-specific cadherin in other, more recently described, types of renal tumor (66% in Xp11 translocation RCCs and 77% in MTSCCs
) carry both diagnostic and histogenetic significance.