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Mucinous tubular and spindle cell carcinomas of the kidney (MTSCC-Ks): CT and MR imaging characteristics

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

To strengthen the recognition of mucinous tubular and spindle cell carcinomas of the kidney (MTSCC-Ks) by analyzing CT and MR imaging findings of MTSCC-Ks.

Materials and methods

This study retrospectively enrolled ten patients with pathologically confirmed MTSCC-Ks from 2007 to 2020. The main observed imaging characteristics included growth pattern, signal characteristics on T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI), hemorrhage, necrosis, cystic degeneration, lipid component, pseudocapsule and the enhancement pattern. Apparent diffusion coefficient (ADC) value of MTSCC-Ks and normal renal cortex were measured, respectively. All imaging features were evaluated in consensus by two genitourinary radiologists.

Results

All patients (53.1 ± 6.5 years, male to female, 3:7) presented with a solitary renal tumor with the mean diameter of 3.5 ± 0.4 cm. All lesions showed iso- or slight hypoattenuation on non-contrast CT with no hemorrhage but cystic degeneration (10%) and necrosis (10%). On T2WI, all lesions showed predominantly slight hypointensity with focal hyperintensity. The ADC value of MTSCC-Ks was 0.845 ± 0.017 × 10−3 mm2/s, and ADCtumor-to-ADCrenal cortex value was 0.376 ± 0.084. Pseudocapsules existed in all MTSCC-Ks on MRI. There were seven lesions showed heterogeneous enhancement, while three lesions showed homogeneous enhancement. Among them, six MTSCC-Ks showed slight multiple patchy enhancement (60%) in the corticomedullary phase, while the remaining MTSCC-Ks showed homogeneously slight enhancement (30%) or slightly stratified enhancement (10%). All MTSCC-Ks exhibited slow and progressive enhancement in the late phases.

Conclusion

Iso- or slight hypoattenuation on CT, slight hypointensity with focal hyperintensity on T2WI, marked diffusion restriction on DWI and ADC map, slight multiple patchy enhancement in the corticomedullary phase, and slow and progressive enhancement in the late phases are the imaging features of MTSCC-Ks, which may facilitate the diagnosis of MTSCC-Ks.

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Data availability

The datasets used during this study are available from the corresponding author on reasonable request.

References

  1. Lopez-Beltran A, Scarpelli M, Montironi R, Kirkali Z. WHO classification of the renal tumors of the adults. Eur Urol. 2006;49:798–805. https://doi.org/10.1016/j.eururo.2005.11.035.

    Article  PubMed  Google Scholar 

  2. Kenney PA, Vikram R, Prasad SR, Tamboli P, Matin SF, Wood CG, Karam JA. Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney: a detailed study of radiological, pathological and clinical outcomes. BJU Int. 2015;116:85–92. https://doi.org/10.1111/bju.12992.

    Article  PubMed  Google Scholar 

  3. Ged Y, Chen Y-B, Knezevic A, Donoghue MTA, Carlo MI, Lee C-H, et al. Mucinous tubular and spindle-cell carcinoma of the kidney: clinical features, genomic profiles, and treatment outcomes. Clin Genitourin Cancer. 2019;17:268-274.e1. https://doi.org/10.1016/j.clgc.2019.04.006.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bai HS, Wang D, Shou JZ, Li CL, Xing NZ. Renal mucinous tubular and spindle cell carcinoma of the kidney: a report of 5 cases and literature review. Oncol Prog. 2019;17:1716–21. https://doi.org/10.11877/j.issn.1672-1535.2019.17.14.28.

    Article  Google Scholar 

  5. Kay FU, Pedrosa I. Imaging of solid renal masses. Urol Clin North Am. 2018;45:311–30. https://doi.org/10.1016/j.ucl.2018.03.013.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Zhao M, He X-L, Teng X-D. Mucinous tubular and spindle cell renal cell carcinoma: a review of clinicopathologic aspects. Diagn Pathol. 2015;10:168. https://doi.org/10.1186/s13000-015-0402-1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Dhillon J, Amin MB, Selbs E, Turi GK, Paner GP, Reuter VE. Mucinous tubular and spindle cell carcinoma of the kidney with sarcomatoid change. Am J Surg Pathol. 2009;33:44–9. https://doi.org/10.1097/PAS.0b013e3181829ed5.

    Article  PubMed  Google Scholar 

  8. Kuroda N, Hes O, Michal M, Nemcova J, Gal V, Yamaguchi T, Kawada T, Imamura Y, Hayashi Y, Lee GH. Mucinous tubular and spindle cell carcinoma with Fuhrman nuclear grade 3, A histological, immunohistochemical, ultrastructural and FISH study. Histol Histopathol. 2008;23:1517–23. https://doi.org/10.14670/HH-23.1517.

    Article  CAS  PubMed  Google Scholar 

  9. Fine SW, Argani P, DeMarzo AM, Delahunt B, Sebo TJ, Reuter VE, Epstein JI. Expanding the histologic spectrum of mucinous tubular and spindle cell carcinoma of the kidney. Am J Surg Pathol. 2006;30:1554–60.

    Article  PubMed  Google Scholar 

  10. Thway K, Du Parcq J, Larkin JMG, Fisher C, Livni N. Metastatic renal mucinous tubular and spindle cell carcinoma. Atypical behavior of a rare, morphologically bland tumor. Ann Diagn Pathol. 2012;16:407–10. https://doi.org/10.1016/j.anndiagpath.2011.04.001.

    Article  PubMed  Google Scholar 

  11. Gong P, Zhuang Q, Wang X, Xu R, Ding T, Yin S, He X. Mucinous tubular and spindle cell carcinoma of the kidney: five case reports and review of the literature. Oncol Lett. 2020;20:337. https://doi.org/10.3892/ol.2020.12201.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Cornelis F, Ambrosetti D, Rocher L, Derchi LE, Renard B, Puech P, et al. CT and MR imaging features of mucinous tubular and spindle cell carcinoma of the kidneys. A Multi-Inst Rev Eur Radiol. 2016;27:1087–95. https://doi.org/10.1007/s00330-016-4469-1.

    Article  Google Scholar 

  13. Takahashi H, Vikram R, Jimenez RE, Bolan CW, Kawashima A, Karam JA, Takahashi N. MR characteristics of mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney: comparison with clear cell and papillary subtypes of renal cell carcinoma. Abdom Radiol (NY). 2021. https://doi.org/10.1007/s00261-021-03227-0.

    Article  Google Scholar 

  14. Sahni VA, Hirsch MS, Sadow CA, Silverman SG. Mucinous tubular and spindle cell carcinoma of the kidney: imaging features. Cancer Imaging. 2012;12:66–71. https://doi.org/10.1102/1470-7330.2012.0008.

    Article  PubMed  Google Scholar 

  15. Kang SK, Huang WC, Pandharipande PV, Chandarana H. Solid renal masses: what the numbers tell us. AJR Am J Roentgenol. 2014;202:1196–206. https://doi.org/10.2214/AJR.14.12502.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Nicolau C, Antunes N, Paño B, Sebastia C. Imaging Characterization of Renal Masses. Medicina (Kaunas). 2021. https://doi.org/10.3390/medicina57010051.

    Article  Google Scholar 

  17. Venkatesh R, Weld K, Ames CD, Figenshau SR, Sundaram CP, Andriole GL, et al. Laparoscopic partial nephrectomy for renal masses: effect of tumor location. Urology. 2006;67:1169–74. https://doi.org/10.1016/j.urology.2006.01.089 (discussion 1174).

    Article  PubMed  Google Scholar 

  18. Konijn LCD, van Overhagen H, Takx RAP, de Jong PA, Veger HTC, Mali WPTM. CT calcification patterns of peripheral arteries in patients without known peripheral arterial disease. Eur J Radiol. 2020;128:108973. https://doi.org/10.1016/j.ejrad.2020.108973.

    Article  PubMed  Google Scholar 

  19. Ho VB, Allen SF, Hood MN, Choyke PL. Renal masses: quantitative assessment of enhancement with dynamic MR imaging. Radiology. 2002;224:695–700. https://doi.org/10.1148/radiol.2243011048.

    Article  PubMed  Google Scholar 

  20. Silverman SG, Israel GM, Herts BR, Richie JP. Management of the incidental renal mass. Radiology. 2008;249:16–31. https://doi.org/10.1148/radiol.2491070783.

    Article  PubMed  Google Scholar 

  21. Yu X, Lin M, Ouyang H, Zhou C, Zhang H. Application of ADC measurement in characterization of renal cell carcinomas with different pathological types and grades by 3.0T diffusion-weighted MRI. Eur J Radiol. 2012;81:3061–6. https://doi.org/10.1016/j.ejrad.2012.04.028.

    Article  PubMed  Google Scholar 

  22. Wang H, Cheng L, Zhang X, Wang D, Guo A, Gao Y, Ye H. Renal cell carcinoma: diffusion-weighted MR imaging for subtype differentiation at 3.0 T. Radiology. 2010;257:135–43. https://doi.org/10.1148/radiol.10092396.

    Article  PubMed  Google Scholar 

  23. Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182:844–53. https://doi.org/10.1016/j.juro.2009.05.035.

    Article  PubMed  Google Scholar 

  24. Paudyal B, Paudyal P, Tsushima Y, Oriuchi N, Amanuma M, Miyazaki M, et al. The role of the ADC value in the characterisation of renal carcinoma by diffusion-weighted MRI. Br J Radiol. 2010;83:336–43. https://doi.org/10.1259/bjr/74949757.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Parwani AV, Husain AN, Epstein JI, Beckwith JB, Argani P. Low-grade myxoid renal epithelial neoplasms with distal nephron differentiation. Hum Pathol. 2001;32:506–12. https://doi.org/10.1053/hupa.2001.24320.

    Article  CAS  PubMed  Google Scholar 

  26. Nathany S, Monappa V. Mucinous tubular and spindle cell carcinoma: a review of histopathology and clinical and prognostic implications. Arch Pathol Lab Med. 2020;144:115–8. https://doi.org/10.5858/arpa.2017-0506-RS.

    Article  CAS  PubMed  Google Scholar 

  27. Srigley JR, Delahunt B, Eble JN, et al. The international society of urological pathology (ISUP) vancouver classification of renal neoplasia. Am J Surg Pathol. 2013;37:1469–89. https://doi.org/10.1097/PAS.0b013e318299f2d1.

    Article  PubMed  Google Scholar 

  28. Wu X, Chen Y, Sha J, Zhao L, Huang J, Bo J-J, et al. Renal mucinous tubular and spindle cell carcinoma: a report of 8 cases and review of the literature. Diagn Pathol. 2013;8:206. https://doi.org/10.1186/1746-1596-8-206.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Min J, Zhang GP, Wang Y, Liu GP, Gu CY, Wang XB. Clinicopathologic analysis of kidney mucinous tubular and spindle cell carcinoma. J Chengdu Med Coll. 2019;14:375–9. https://doi.org/10.3969/j.issn.1674-2257.2019.03.024.

    Article  CAS  Google Scholar 

  30. Moch H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. The 2016 WHO classification of tumours of the urinary system and male genital organs-part a: renal, penile, and testicular tumours. Eur Urol. 2016;70:93–105. https://doi.org/10.1016/j.eururo.2016.02.029.

    Article  PubMed  Google Scholar 

  31. Cornelis F, Ambrosetti D, Rocher L, Derchi LE, Renard B, Puech P, et al. CT and MR imaging features of mucinous tubular and spindle cell carcinoma of the kidneys. A Multi-Inst Rev Eur Radiol. 2017;27:1087–95. https://doi.org/10.1007/s00330-016-4469-1.

    Article  CAS  Google Scholar 

  32. Noon AP, Smith DJ, McAndrew P. Magnetic resonance imaging characterization of a mucinous tubular and spindle cell carcinoma of the kidney detected incidentally during an ectopic pregnancy. Urology. 2010;75:247–8. https://doi.org/10.1016/j.urology.2009.09.047.

    Article  PubMed  Google Scholar 

  33. Zhu Q, Zhu W, Wang Z, Wu J. Clinical and CT imaging features of mucinous tubular and spindle cell carcinoma. Chin Med J. 2014;127:1278–83.

    PubMed  Google Scholar 

  34. Young JR, Margolis D, Sauk S, Pantuck AJ, Sayre J, Raman SS. Clear cell renal cell carcinoma: discrimination from other renal cell carcinoma subtypes and oncocytoma at multiphasic multidetector CT. Radiology. 2013;267:444–53. https://doi.org/10.1148/radiol.13112617.

    Article  PubMed  Google Scholar 

  35. Cornelis F, Tricaud E, Lasserre AS, Petitpierre F, Bernhard JC, Le Bras Y, et al. Routinely performed multiparametric magnetic resonance imaging helps to differentiate common subtypes of renal tumours. Eur Radiol. 2014;24:1068–80. https://doi.org/10.1007/s00330-014-3107-z.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

None.

Funding

National Natural Science Foundation of China (No. 81971580); National Natural Science Foundation of China (No. 81471641).

Author information

Author notes

  1. Huanhuan Kang and Wei Xu contributed equally to this work.

Authors and Affiliations

  1. Medical School of Chinese PLA, Beijing, 100853, China

    Huanhuan Kang

  2. Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Huanhuan Kang, Wei Xu, Shuxiang Chang, Jing Zhang, Huiping Guo, Huiyi Ye & Haiyi Wang

  3. Department of Pathology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China

    Jing Yuan

  4. Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China

    Xu Bai

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Contributions

HK: data acquisition and analysis, literature search, methodological advice, formal analysis, manuscript preparation, manuscript editing, critical revision of the manuscript. WX: manuscript preparation, manuscript editing, systematic search process, methodological advice. SC: data analysis, methodological advice. JY: systematic search process, methodological advice, pathological analysis. XB: systematic search process, methodological advice. JZ: data acquisition, systematic search process. HG: data acquisition and analysis. HY: concept, methodological advice. HW: concept, Supervision, Project administration, Funding acquisition, manuscript review. All authors declare to have approved the final version of the manuscript.

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Correspondence to Haiyi Wang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (approval number: S2021-103–01).

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Kang, H., Xu, W., Chang, S. et al. Mucinous tubular and spindle cell carcinomas of the kidney (MTSCC-Ks): CT and MR imaging characteristics. Jpn J Radiol 40, 1175–1185 (2022). https://doi.org/10.1007/s11604-022-01294-x

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