Integrated Imaging-Pathologic Diagnosis and Treatment Overview of Mucinous Tubular and Spindle Cell Renal Cell Carcinoma: A Case Report and Systematic Review of the Literature.

Introduction: Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney is a rare, low-grade renal epithelial tumor with a unique histopathological profile. This case report aimed to highlight the clinical, imaging, and immunohistochemical features of MTSCC, facilitating its differentiation from other renal tumors and providing insight into effective management strategies.

Case presentation: A 52-year-old female presented with left-sided abdominal pain. Imaging studies, including CT and ultrasound, revealed a low-density mass in the left kidney. The patient subsequently underwent laparoscopic radical nephrectomy. Pathological examination identified spindle and cuboidal epithelial cells forming elongated tubules with mild atypia within a mucinous stroma. Immunohistochemical staining showed positivity for CK7, P504S, and PAX8, confirming the diagnosis of MTSCC. Postoperatively, the patient was managed conservatively without chemotherapy or radiotherapy and received only symptomatic treatment. During a 24-month follow-up, she demonstrated favorable recovery with no signs of recurrence or metastasis.

Conclusion: This case underscores the critical role of imaging, histopathology, and immunohistochemistry in accurately diagnosing MTSCC. Early detection and timely surgical intervention can lead to positive outcomes, as illustrated by this patient's recovery. Further research is needed to explore the molecular mechanisms of MTSCC and establish robust guidelines for its management.