Nadir Görülen Bir Böbrek Tümörü: Müsinöz Tubuler ve İğsi Hücreli Karsinoma

Müsinöz tübüler ve iğsi hücreli karsinoma; oldukça nadir görülen renal epitelyal bir neoplazmdır. Olgu sunumumuzda müsinöz tübüler ve iğsi hücreli karsinoma saptanan olgu sunulmuş ve hastalığın epidemiyolojisi, radyolojik bulguları ve histopatolojik özellikleri ilgili literatür eşliğinde kısaca tartışılmıştır. 43 yaşındaki erkek hasta, sol yan ağrısı şikayeti ile başvurduğu dış merkezde yapılan radyolojik incelemede, sol böbreğinde kitle saptanması üzerine ileri tanı ve tedavi için hastanemiz üroloji polikliniğine yönlendirildi. Yapılan fizik muayene ve tetkikler doğrultusunda renal hücreli karsinoma düşünülen olguya radikal nefrektomi operasyonu planlandı. Materyalden hazırlanan kesitlerin mikroskobik incelemesinde; miksoid stroma içerisinde, eozinofilik sitoplazmalı, iğsi şekilli, düşük gradeli nükleer özellikler gösteren hücrelerin, uzamış veya birbiri ile anastomozlaşan tubul benzeri yapılanmalarından oluşan tümöral lezyon dikkati çekti. Histopatolojik ve immünohistokimyasal bulgular doğrultusunda olguya müsinöz tübüler ve iğsi hücreli karsinoma tanısı verildi. Tüm renal neoplazilerin %1'den azını oluşturan bu tümörlerin prognozu, diğer epitelyal böbrek tümörlerine kıyasla daha iyidir. Bu nedenle müsinöz tübüler ve iğsi hücreli karsinoma olgularını ayırıcı tanıya girdikleri papiller renal hücreli karsinoma olgularından ayırmak son derece önemlidir.

A Rarely Seen Renal Epithelial Tumor: Mucinous Tubular and Spindle Cell Carcinoma

Mucinous tubular and spindle cell carcinoma has recently been recognized as a rare distinctive type of renal epithelial carcinoma. In our case report, we report a case of mucinous tubular and spindle cell carcinoma and epidemiology, radiological findings and histopathologic features of the disease were briefly discussed in literature data. A 43-year-old male was referred to our urology outpatient clinic for further diagnosis and treatment after a mass on the left kidney was detected in a radiological examination at the external center with the complaint of left flank pain. Radical nephrectomy was planned for the case who was thought to have a diagnosis of renal cell carcinoma according to physical examination and tests. In the microscopic examination of the specimen, tumoral lesion consisting of elongated or anastomotic tubulus-like structures of the spindle shaped cells with eosinophilic cytoplasm indicating low-grade nuclear features consistent in myxoid stroma were observed. The patient was diagnosed as mucinous tubular and spindle cell carcinoma according to the histopathological and immunohistochemical findings. These tumors, which constitute less than 1% of all renal neoplasms, have a better prognosis than other epithelial renal tumors. Therefore, it is very important to distinguish mucinous tubular and spindle cell carcinoma cases from papillary renal cell carcinoma cases in differential diagnosis.

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