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Case of the Week

2021-27/ July 6

Contributors:  Levent Trabzonlu, Maria M. Pickens, Guliz Akdas Barkan

A woman in her 50s presents with a right flank / lower abdominal discomfort. Her past medical history is not significant. Ultrasound reveals a 9 cm right renal mass.

Click on the below thumbnails to enlarge photos.

5 photo(s) Updated on: July 04, 2021
  • HE, 20X
  • HE, 200X, foamy macrophages.
  • HE, 200X, intercellular mucin.
  • Racemase, 200X.
  • CD10, 200X


1.  What is the correct diagnosis?

a. Papillary renal cell carcinoma, Type-1

b. Mucinous tubular and spindle cell carcinoma

c. Metanephric adenoma

d. Collecting duct carcinoma

e. Clear cell renal cell carcinoma

2. Which of the following is most useful and reliable to distinguish mucinous tubular and spindle cell carcinoma from papillary renal cell carcinoma in a challenging case?

a. CD10 positivity

b. Tumor circumscription

c. Presence of foamy macrophages and papillary structures

d. Low nuclear grade

e. Absence of chromosomal gains in chromosomes 7 and 17

3. Which of the following is associated with adverse histology and aggressive clinical outcome in mucinous tubular and spindle cell carcinoma of the kidney?

a. VST2MA overexpression

b. CDKN2A/B loss

c. Loss of chromosomes 1, 4, and 6

d. CK7 expression

e. PAX8 expression

About GUPS

The Genitourinary Pathology Society (GUPS) was formed with the vision of advancing the care of patients with urologic diseases through enhancements of best practices, research, and education in the subspecialty of Urological Pathology.

GUPS is an official Companion Society of the United States and Canadian Academy of Pathology (USCAP).



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