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Pathology for Urologists

Mucinous Tubular and Spindle Cell Carcinoma

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  • Renal carcinoma that shows an unusual growth of having biphasic pattern of tubular and spindled epithelial cells and with mucinous stroma.
  • Uncommon, female>male (4:1).
  • Majority discovered incidentally.
  • Multiple chromosomal losses involving 1, 4q, 6, 8p, 11q, 13, 14 and 15, and gains involving 11q, 16q, 17, and 20q.
  • Gross: Well-circumscribed tumor with gray-white to tan cut surface.

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  • Histology:
  • Morphologic and immunohistochemical overlap with sarcomatoid papillary type 1 RCC (main DDX).
    • Tubular cells may look similar + spindle cells in sarcomatoid change.
    • Both tumors are CK7+ and AMACR+.
    • However, papillary RCC lacks extracellular mucin and shows trisomy 7 and 17. (Distinction is often morphologic)
  • Mostly have good prognosis. (Distinction from the more aggressive sarcomatoid papillary RCC is thus important)


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