Significant Response to Nivolumab Plus Ipilimumab in Metastatic Mucinous Tubular and Spindle Cell Carcinoma: A Case Report

IF 0.5 Q4 Medicine

IJU Case Reports Pub Date : 2026-06-01 DOI:10.1002/iju5.70204

Sho Shimasaki, Shinkuro Yamamoto, Mitsuko Iguchi, Erika Yamashita, Kaya Atagi, Yuhei Shiba, Satoshi Fukata, Hirofumi Satake, Takashi Karashima, Keiji Inoue

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Abstract

Introduction

Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare renal cell carcinoma subtype that is typically indolent but may exhibit aggressive behavior. No standard systemic therapy has been established for metastatic MTSCC.

Case Presentation

A 71-year-old woman underwent retroperitoneoscopic radical left nephrectomy for MTSCC (pT1b). Six months later, computed tomography (CT) and ¹⁸F-fluorodeoxyglucose positron emission tomography (PET)/CT revealed lung, bone, and adrenal metastases. Bone biopsy confirmed metastatic MTSCC, and the patient was classified as poor risk. Combination therapy with nivolumab and ipilimumab was initiated. After two cycles, PET/CT showed marked regression of metastatic lesions (SUV_max decreased from 21.7 to 4.3). RECIST evaluation demonstrated a partial response. Genomic profiling revealed microsatellite stability and a low tumor mutational burden, with no clinically actionable alterations identified on FoundationOne CDx. No disease progression was observed at 9 months.

Conclusion

This case demonstrates the potential efficacy of combination immunotherapy in aggressive metastatic MTSCC.

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Nivolumab联合Ipilimumab治疗转移性粘液管状细胞癌和梭形细胞癌的显著疗效：1例报告

粘液管状梭形细胞癌（MTSCC）是一种罕见的肾细胞癌亚型，通常表现为惰性，但可能表现出侵袭性行为。目前还没有针对转移性MTSCC的标准全身治疗方法。一例71岁女性因MTSCC （pT1b）接受后腹膜镜根治性左肾切除术。6个月后，计算机断层扫描（CT）和18f -氟脱氧葡萄糖正电子发射断层扫描(PET)/CT显示肺、骨和肾上腺转移。骨活检证实转移性MTSCC，并将患者分类为低风险。开始纳武单抗和伊匹单抗联合治疗。2个周期后PET/CT显示转移灶明显消退（SUVmax由21.7降至4.3）。RECIST评估显示部分反应。基因组分析显示微卫星稳定性和低肿瘤突变负担，在FoundationOne CDx上没有发现临床可操作的改变。9个月时未见疾病进展。结论联合免疫治疗对侵袭性转移性MTSCC有潜在疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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