Squamous cell carcinoma of the renal pelvis associated with kidney stones: a case report

An Interesting Finding of Xanthogranulomatous Pyelonephritis Revealed Concomitant Incidental Squamous Cell Carcinoma (SCC) of the Renal Pelvis

Squamous cell carcinoma, originating in the renal pelvis, is an infrequent form of kidney malignancy. The occurrence rate remains below 1% for all neoplasms in this specific area. Most of these carcinomas are moderately or poorly differentiated, and diagnosis typically occurs at an advanced stage. Xanthogranulomatous pyelonephritis is an uncommon form of severe chronic infection that affects the parenchyma of native kidneys. We present the case of a 34-year-old male with a history of end-stage renal disease secondary to recurrent pyelonephritis, which was incidentally diagnosed as renal squamous cell carcinoma (SCC).

An unexpected recurrence of rectal squamous cell cancer presenting as deep vein thrombosis

Tumor thrombus is an uncommon oncologic complication and is exceedingly rare in the setting of colorectal cancer. We present the case of a 71-year-old woman with a significant oncologic history, including rectal squamous cell cancer, who presented with left lower extremity deep vein thrombosis. She underwent left lower extremity venography and thrombectomy of the left common iliac vein. Pathologic examination revealed fragments of squamous cell carcinoma embedded in an organizing thrombus. A covered stent was placed in the common iliac vein across the internal iliac vein origin. Positron emission tomography-computed tomography confirmed mediastinal and retroperitoneal lymphadenopathy, which was managed with adjuvant carboplatin and paclitaxel chemotherapy.

Incidental Diagnosis of Renal Pelvic Tumor in Patients Who Underwent Percutaneous Nephrolithotomy: A Report of 6 Cases and Review of the Literature

OBJECTIVES

To report the clinical characteristics of patients who were incidentally diagnosed as renal pelvic tumor during or after percutaneous nephrolithotomy (PNL).

METHODS

The profiles of about 8,000 patients who underwent PNL in our center from 2011 to 2021 were retrospectively reviewed, 6 patients were diagnosed with renal pelvic tumor during or after PNL. Clinical data of these six patients were collected and summarized.

RESULTS

Four males and two females with the average age of 59 years were researched. Chief complaints included loin pain, gross hematuria, and wound infection after PNL. Two patients had a definite long history of stones. Urinary tract infection occurred in 5 patients and all six patients had gross hematuria or microscopic hematuria. CT images revealed severe hydronephrosis in 4 patients and moderate hydronephrosis in 2 patients. Both staghorn and multiple stones were separately seen in 3 patients. Five patients were diagnosed with renal pelvic urothelial carcinoma via biopsy during PNL. One patient was diagnosed as renal pelvic tumor with extensive invasion by postoperative CT scan and received palliative treatment. Of two patients underwent radical surgery, one patient obtained long survival, one patient received endoscopic tumor resection and also obtained long survival. Two patients underwent renal artery embolization, one patient was still alive after 22 months, the other patient showed tumor growth in 3 weeks.

CONCLUSIONS

The possibility of renal pelvic tumor should be considered in stone patients with several risk factors including elder age, long history of stones, complicated stones, hydronephrosis especially pyonephrosis, obvious hematuria etc.

Incidentally detected primary squamous cell carcinoma of the kidney: Case series with review of the literature

ABSTRACT

Squamous cell carcinoma of the kidney is a rare malignancy, usually not suspected clinically because of the lack of any pathognomic sign and ambiguous clinical and radiological features, and thus, patients present at advanced stages resulting in poor prognosis. We report here four cases of incidentally diagnosed primary renal squamous cell carcinoma that were treated at our hospital. The mean age of the patients (two females and one male aged above 60 years, except one male whose age was 25 years) was 60 years. Both the males and one of the females had a history of multiple renal calculi, and the other female had staghorn calculus. Interestingly, renal carcinoma was not suspected clinically in all these patients. In one case, a computerized tomography scan (CT scan) showed suspicious mass. All underwent nephrectomy for the non-functioning kidney. In only two cases, tumor was identified on gross examination, whereas the other two only showed a distorted pelvis. Our case series emphasizes the need for pelvicalyceal biopsy during diagnosis and treatment for long-standing nephrolithiasis and thorough sampling of nephrectomy specimens of such patients to rule out malignancy.

Pelvicalyceal Squamous Cell Carcinoma: Incidental Diagnosis With Liver Metastasis on Follow Up

Primary squamous cell carcinoma (SCC) of the renal pelvis is a rare malignancy. We report a case of a 43-year-old male presenting with stones and a non-functioning kidney. Incidental SCC was diagnosed histopathologically on nephrectomy. The patient then returned with metastasis to the liver after one year. Nephrolithiasis is the most important risk factor implicated in renal SCC; hence, awareness of this rare entity in a patient of long-standing nephrolithiasis is important.

A case report of complete pathological remission after chemotherapy in a patient with primary renal squamous cell carcinoma

This is the first case report of the outcomes of systemic chemotherapy in a patient with locally advanced renal squamous cell carcinoma, a rare tumor, as well as the first next generation sequencing study of this rare tumor. The patient's main symptoms were fever and low back pain. Initial positron emission tomography and computed tomography (PET-CT) suggested a malignant renal tumor at onset, but biopsy confirmed renal squamous cell carcinoma. Next generation sequencing showed a low level of microsatellite instability (MSI-L), a high tumor mutational burden (TMB-H), a high neoantigen burden (TNB-H), and a strong loss of heterozygosity (LOH) for human leukocyte antigen (HLA), with 67 deleterious mutations. The patient achieved partial radiological remission after a cycle of systemic chemotherapy with albumin-bound paclitaxel combined with nedaplatin. After radical resection of the left renal tumor, postoperative pathology confirmed complete tumor remission and tumor-like xanthogranulomatous pyelonephritis. Conclusion: This renal squamous cell carcinoma patient responded to systemic chemotherapy with paclitaxel combined with platinum, providing a reference for the future treatment of similar cases. Pathology and gene sequencing indicated that renal squamous cell carcinoma occurred in a background of active inflammation and that the tumor evolved immune escape mechanisms such as loss of HLA heterozygosity, with gene repair defects and TMB-H.

Renal Squamous Cell Carcinoma-related Polymyositis in a Patient with Autosomal Dominant Polycystic Kidney Disease

A 74-year-old Japanese woman diagnosed with autosomal dominant polycystic kidney disease (ADPKD) was admitted to our institute for the further examination of right-side groin pain developing in the past week. The patient was diagnosed with polymyositis (PM). Diagnostic imaging showed a mass lesion measuring 8 cm and a renal stone in the right kidney. Immediately following surgical resection of the right kidney, the patient's serum CK decreased to the normal range. A histopathological analysis showed well-differentiated squamous cell carcinoma. In conclusion, this case showed a close relationship between the occurrence of squamous cell carcinoma and the development of PM in an ADPKD patient.

Incidental squamous cell carcinoma of renal pelvis presenting as skin invasion: a case report

Introduction

Squamous cell carcinoma of the renal pelvis is a rare neoplasm, accounting for less than 0.8% of malignant renal tumors. Chronic irritation is believed to be the primary pathogenic cause for squamous cell carcinoma of the renal pelvis. The most frequently reported cases of squamous cell carcinoma of the renal pelvis generally present with hydronephrosis, pyelonephritis, or nephrolithiasis. The skin of the flank is a very uncommon site of clinical presentation. Here, we report an exceedingly rare case of squamous cell carcinoma of the renal pelvis presenting as skin invasion of the flank.

Case presentation

A 66-year-old Han Chinese man consulted our hospital because of a right lumbar skin lesion lasting more than 3 months. His physical examination revealed that he had a palpable mass about 6.0 cm × 5.0 cm in size at the posterior axillary line in the right low back with skin ulceration 3 mm in diameter and exudation on it. Magnetic resonance imaging showed hydronephrosis of the right kidney and plaque-like abnormal signal in the middle portion of the kidney. The patient underwent a right nephrectomy. The sinus tract formation between the ulcerative skin in the right low back and the middle portion of the right kidney could be found. The distended kidney could not be excised entirely for tight adhesion. Pathological examination showed moderately differentiated renal squamous cell carcinoma with invasion of the renal parenchyma and perirenal adipose tissue.

Conclusion

It is extremely rare for renal squamous cell carcinoma to present as skin invasion. Recurrent percutaneous nephrolithotomy may be a risk factor for squamous cell carcinoma of the renal pelvis. The possibility of renal squamous cell carcinoma should be kept in mind in patients who have hydronephrosis, nephrolithiasis, or chronic pyelonephritis for a long time or with renal anomalies. More radiological examinations are suggested for such patients.

Primary squamous cell carcinoma of the kidney: a case report and review of the literature

Background

Primary squamous cell carcinoma (SCC) of the kidney is a rare entity which tends to be associated with nephrolithiasis, chronic irritation, and infection. Due to its rarity and the non-specific clinical signs and symptoms as well as radiological findings, it is often not suspected preoperatively. Patients with SCC of the renal pelvis typically present with advanced stage disease and have a poor outcome. Most of our current knowledge of SCC of the renal pelvis has been derived from case reports or limited case series, and there are no standard treatment guidelines. The clinical, radiological, and histopathological findings of this unusual neoplasm are described herein.

Case presentation

A 61-year-old female presented with left flank pain and sepsis. A computerized tomography (CT) scan showed renal calculi and hydronephrosis, and a mercapto-acetyl triglycine (MAG-3) scan showed a left-sided non-functioning kidney. She underwent a nephrectomy for an infected, non-functioning kidney. Histopathological examination revealed an invasive, moderately differentiated squamous cell carcinoma.

Conclusion

The significance of this case is highlighted by the unusual location of such a tumour, and while rare, it is an important consideration in the differential diagnoses of renal tumours. The present case report may assist patient management of this rare tumour by highlighting and documenting treatment and clinical outcome of our patient.

Primary renal pelvis and ureter squamous cell carcinoma (SCC): a rare case report and review of literature

Primary renal squamous cell carcinoma (SCC) is a very rare upper urinary tract neoplasm. Renal SCC has a poor prognosis because it usually presents in advanced stages. We report a 64-year-old woman with a right paravertebral mass; after right radical nephroureterectomy and salpingo-oophorectomy, pathologic examination revealed primary SCC.

Epidemiology of urothelial carcinoma

The epithelium lining is defined as the mucosal surfaces of the renal collecting tubules, calyces and pelvis, as well as the ureter, bladder and urethra. The term "urothelium" is used to refer to these surfaces. Upper tract urothelial carcinoma is a rare subset of urothelial cancers with a poor prognosis. Urinary bladder cancer is the most common malignancy involving the urinary system. Upper tract urothelial carcinoma is more common in men than in women, with a male-to-female ratio of 2:1. The incidence of urinary bladder cancer is also higher in men. Cigarette smoking and occupational exposure are the main upper tract urothelial carcinoma and urinary bladder cancer risk factors, while other factors are more specific to the carcinogenesis of upper tract urothelial carcinoma (i.e. Balkan endemic nephropathy, Chinese herb nephropathy). In Egypt until recent years, urinary bladder cancer was the most frequently diagnosed cancer due to Schistosoma haematobium. Substantial knowledge exists regarding the causes of upper tract urothelial carcinoma and urinary bladder cancer, and epidemiological studies have identified various chemical carcinogens that are believed to be responsible for most cases of urothelial carcinoma. In the era of precision medicine, genetic effects might play a direct role in the initiation and progression of urothelial carcinoma.

A Case of Solitary Kidney Atrophy Due to Primary Hyperparathyroidism: A Case Report

Although primary hyperparathyroidism (PHPT) is asymptomatic in most patients, its main clinical manifestation is nephrolithiasis. In general, hypercalcemia would lead to unilateral renal stones, which may become bilateral over time. We present a rare case of a large unilateral asymptomatic ureteral stone in a patient with hypercalcemia secondary to PHPT, which eventually led to renal atrophy.The diagnosis of PHPT should be considered in patients with hypercalcemia and renal stones, as asymptomatic PHPT may result in a devastating renal outcome.

Primary renal squamous cell carcinoma mimicking the renal cyst: a case report and review of the recent literature

Background

Renal squamous cell carcinoma is a rare neoplasm with poor prognosis. Chronic irritation from nephrolithiasis and/or pyelonephritis is the leading cause.

Case presentation

We described a 51-year-old male patient who was admitted because of left flank pain. Ultrasonography showed a renal cyst containing calculus. However, contrast-enhanced ultrasonography and CT scan revealed an irregular-shaped mass derived from a calculi-containing cyst. Ultrasound guided biopsy confirmed the diagnosis of renal squamous cell carcinoma. The patient refused any further therapeutic management and died six months later.

Conclusions

Our present case emphasizes that the careful diagnostic work-up and use of multiple imaging modalities in cases of unusual renal calculi is quite necessary, since they may carry the risk of co-existing hidden malignancy.

Squamous Upper Tract Carcinoma Presenting as a Perinephric Abscess

Perinephric abscesses are life-threatening conditions, which are rarely associated with neoplasms of the kidney or upper tract collecting system. We report, to our knowledge, the first case of squamous carcinoma of the upper tract presenting as a perinephric abscess, diagnosed after radical nephrectomy.