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Paciente de 36 años, primigesta, con gestación de 37 semanas y sin antecedentes de interés, a la que se le practica una cesárea por fracaso de inducción. Tras realizar la laparotomía, se objetivan múltiples nódulos firmes y blanquecinos, de manera diseminada por toda la cavidad abdominal, de tamaños comprendidos entre 0,2-0,5cm. Con sospecha clínica de carcinomatosis peritoneal, se realizan biopsias de ovario, vejiga, epiplón y apéndice epiploico. Tras la intervención, se realiza TAC toraco-abdomino-pélvico, que es informado como hallazgos en relación con carcinomatosis y ascitis. El estudio morfológico e inmunohistoquímico apoyó el diagnóstico de deciduosis peritoneal difusa. Presentamos un caso poco frecuente y muy exhuberante de deciduosis peritoneal. Cuando es difusa, es importante realizar el diagnóstico diferencial, principalmente con metástasis tumorales y el mesotelioma deciduoide, ya que a diferencia de estas entidades, la deciduosis peritoneal difusa es un proceso que suele evolucionar a la regresión espontánea tras el parto (AU)

We report a case of rare, florid peritoneal deciduosis in a 36 year old patient who underwent a caesarean section at the 37th week of her first pregnancy after labour induction failed. She had an unremarkable previous medical history. On laparotomy, multiple firm, whitish nodules measuring between 0.2 and 0.5cm were seen in the abdominal cavity. As peritoneal carcinomatosis was suspected, biopsies were taken of ovaries, bladder, omentum and appendix. A thoraco-abdominopelvic CT scan was performed postoperatively which showed abdominal-peritoneal involvement and ascites. Histopathology and immunohistochemistry confirmed a diagnosis of diffuse peritoneal deciduosis. Diffuse peritoneal deciduosis must be carefully differentiated from tumour metastases and deciduoid mesothelioma as it usually regresses spontaneously after delivery (AU)

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OBJECTIVE: To describe two cases of a rare type of renal tumor , mucinous tubular and spindle cell carcinoma (MTSC), with different pathologic features. METHODS: We present: 1) the case of a 36 year-old woman 24-week pregnant, in whom during an examination for a renal colic we discovered a 5.5 cm tumor in the lower pole of the left kidney. 2) A 71-year-old woman that consulted to her doctor due to loss of weight (5 kg) and anorexia. A 15 x 12 x 9.5 cm tumor was found in her left kidney. RESULTS: Radical nephrectomy was performed in both cases. Microscopic examination showed a myxoid matrix containing a proliferation of tubules and spindle cells, with low-grade atypia. Cells were immunoreactive for CK7, racemase, EMA and vimentin and negative for CD10. Case 1 had some foci of papillary morphology, and was pT1. Case 2 had some nests of clear cells and invaded the sinus fat focally. It was staged as pT3a. In April 2012, the patients are alive without evidence of recurrence or metastasis after 13.5 years (case 1) and 8 months (case 2) of follow up. CONCLUSIONS: MTSC is a rare type of renal carcinoma, which can appear with different clinical, gross and microscopic features. This tumor seems to share some morphological and immunohistochemical similarities with renal papillary carcinoma, and the differential diagnosis is difficult. The vast majority of cases reported had favourable evolution, like our case 1, although a remote possibility of metastasis exists, in cases with sarcomatoid differentiation, but even without it.

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OBJETIVO: Describir dos casos de un tipo raro de tumor renal, el carcinoma mucinoso tubular y fusocelular (CMTF), con diferentes características anatomopatológicas. MÉTODO: Presentamos. 1) el caso de una mujer de 36 años, gestante de 24 semanas, en la que, durante la exploración de un cólico nefrítico, se descubrió un tumor en el polo inferior del riñón izquierdo, de 5.5 cm, y 2), una mujer de 71 años que consultó a su médico por pérdida de peso (5 kg) y anorexia. Se encontró un tumor de 15 X 12 X 9.5 cm en el riñón izquierdo. RESULTADOS: Se realizó nefrectomía radical en ambos casos. Las características microscópicas nos permitieron clasificarlos como CMTF: se observó sobre una matriz mixoide una proliferación de túbulos y células fusiformes, con atipia de bajo grado. Las células eran inmunorreactivas para CK7, racemasa, EMA y vimentina y negativas para CD10. El caso 1 tenía algunos focos de morfología papilar, y fue pT1. El caso 2 tenía algunos nidos de células claras, e invadía focalmente la grasa del seno. Se clasificó como estadio pT3a. En Abril de 2012, las pacientes están vivas, sin recidiva ni metástasis tras 13.5 años (caso 1) y 8 meses (caso 2) de seguimiento. CONCLUSIONES: El CMTF es un tipo infrecuente de carcinoma renal, que se puede presentar con características clínicas, macro y microscópicas variadas. Este tumor parece compartir algunas similitudes morfológicas e inmunohistoquímicas con el carcinoma papilar renal, siendo difícil el diagnóstico diferencial con este. Aunque la gran mayoría de los casos comunicados presenta una evolución favorable, como nuestro caso 1, existe la posibilidad remota de metástasis, en casos con diferenciación sarcomatoide, pero incluso sin ella

OBJECTIVE: To describe two cases of a rare type of renal tumor, mucinous tubular and spindle cell carcinoma (MTSC), with different pathologic features. METHODS: We present: 1) the case of a 36 year-old woman 24-week pregnant, in whom during an examination for a renal colic we discovered a 5.5 cm tumor in the lower pole of the left kidney. 2) A 71-year-old woman that consulted to her doctor due to loss of weight (5 kg) and anorexia. A 15 X 12 X 9.5 cm tumor was found in her left kidney. RESULTS: Radical nephrectomy was performed in both cases. Microscopic examination showed a myxoid matrix containing a proliferation of tubules and spindle cells, with low-grade atypia. Cells were immunoreactive for CK7, racemase, EMA and vimentin and negative for CD10. Case 1 had some foci of papillary morphology, and was pT1. Case 2 had some nests of clear cells and invaded the sinus fat focally. It was staged as pT3a. In April 2012, the patients are alive without evidence of recurrence or metastasis after 13.5 years (case 1) and 8 months (case 2) of follow up. Conlcuisons: MTSC is a rare type of renal carcinoma, which can appear with different clinical, gross and microscopic features. This tumor seems to share some morphological and immunohistochemical similarities with renal papillary carcinoma, and the differential diagnosis is difficult. The vast majority of cases reported had favourable evolution, like our case 1, although a remote possibility of metastasis exists, in cases with sarcomatoid differentiation, but even without it

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We describe a case of solid cell nest hyperplasia associated with papillary thyroid carcinoma in a 48-year-old man with goiter. The entire gland was examined; in 1 section, the cells of 1 solid cell nest were in close contact with a follicular variant of papillary microcarcinoma. A second follicular variant of papillary microcarcinoma, 1 follicular adenoma, hyperplastic nodules, and some lymphoid aggregates were also found. Scattered p63-positive cells were found in the second papillary microcarcinoma. After microdissection, the same BRAF(V600E) mutation was found both in a pool of 5 solid cell nests and in the adjacent papillary microcarcinoma. BRAF(V600E) mutation and the previously unreported BRAF(G593D) mutation along with p.G606G silent change were found in the second papillary microcarcinoma, but no mutations were detected in the follicular adenoma or in the 2 other pools of solid cell nests screened for BRAF gene mutations. These findings support a histogenetic link between the main cells of solid cell nests and papillary thyroid carcinoma, and suggest solid cell nest hyperplasia as a precursor lesion of papillary thyroid carcinoma.

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