Two Rare Entities in One Patient: Mucinous Tubular and Spindle Cell Carcinoma of the Kidney and Peritoneal Adenomyomas

Abstract

Mucinous tubular and spindle cell carcinoma of the kidney is a rare subtype of renal cell carcinoma, that is believed to portend a favorable prognosis. Adenomyomas are benign tumors that typically arise from the myometrium. Extrauterine adenomyomas are extremely rare, with only a few cases reported in the literature. Here, we present an unusual case of a 46-year-old woman, with an incidentally detected bulky interpolar left kidney mass measuring 12 cm and multiple lobulated coalescent peritoneal nodules in the large epiploon suspicious for peritoneal carcinomatosis. A biopsy of the lesions revealed a mucinous tubular and spindle cell carcinoma of the kidney and extrauterine adenomyomas of the peritoneum. A left radical nephrectomy was performed and long-term hormone therapy with gonadotropin-releasing hormone agonists was prescribed. The purpose of this article is to focus on these two rare lesions, review the current literature, illustrate their key imaging findings along with pathologic correlation, as well as to discuss the differential diagnosis and clinical management.

A case report of robot-assisted laparoscopic left renal mucinous cystadenocarcinoma radical nephrectomy and review of literature

“…In addition, the tumor is located in the renal parenchyma with expansive growth and a cystic-solid tumor is located in the renal parenchyma with expansive growth and a cystic-solid tumor with a clear boundary as determined by imaging. Plain CT scans are generally isodense or have low density [9]. Enhanced CT showed that the density of the tumor was signi cantly lower than that of the renal cortex and medulla [10].…”

Case report and literature review: Robot-assisted laparoscopic left renal mucinous cystadenocarcinoma radical nephrectomy

“…In addition, the tumor is located in the renal parenchyma with expansive growth and a cystic-solid tumor with a clear boundary as determined by imaging. Plain CT scans are generally isodense or have low density (10). Enhanced CT showed that the density of the tumor was significantly lower than that of the renal cortex and medulla (11).…”

Extrauterine adenomyoma: A case report and systematic review of the literature

“…Although the exact pathophysiology underlying this association is unknown, the prevalence of concurrent EA and malignancy deserves the attention of clinicians to further investigate the patients affected by EA and vice versa. 42,51,57,63,81,82,89,90 Further studies are needed to assess the relationship between EA and malignancy.…”

“…In contrast, the cystic spaces appeared hyperintense on both T1 and T2 images. Considered to be an endometriotic cyst Gruttadauria 2020 26 3-cm complex mass of the right ovary, 7-cm complex mass anterior to the rectum, left adnexal mass separate from the ovary Alves 2021 90 Multiple lobulated iso-to hypodense coalescent peritoneal nodules with more expression in the greater omentum that showed moderate enhancement, suggestive of peritoneal carcinomatosis…”

“…By immunohistochemistry, the endometrial glands were immunoreactive to ER and PAX-8, the stroma were immunoreactive to CD10 and ER. The smooth muscle wall was highlighted by desmin immunostaining Liberale 2020 89 Presence of two endometriotic cysts surrounded by a variable thickness of smooth muscle layers lined with endometrial glands and stroma without nuclear atypia resembling normal uterine myometrium and endometrium Ramphal 2020 47 Well-circumscribed lesion composed of foci of benign endometrial glands and endometrial stroma surrounded fat and connective tissue Alves 2021 90 Composed of whirling bland smooth muscle tissue with benign endometrial glands randomly distributed surrounded by a rim of endometrial stroma. There was no significant atypia, mitotic activity, or necrosis.…”