Incidentally detected squamous cell carcinoma in non-functioning kidney presenting as multi-cystic mass

Special pathological type of upper urinary tract malignancy-squamous cell carcinoma of the renal pelvis: A case report and literature review

Objective

To investigate the clinnical features for squamous cell carcinoma (SCC) of the renal pelvis.

Methods

We analyzed the medical records of a patient diagnosed with SCC of the renal pelvis and performed a literature review.

Results

SCC of the renal pelvis is a rare pathological type of upper urinary tract malignancy with nonspecific clinical features. Its diagnosis relies on postoperative pathology and immunohistochemistry. Radical resection is the gold standard for treatment.

Conclusion

Patients with long-term urothelial irritation should be regularly screened, pathogenic factors should be proactively addressed, and vigilance should be maintained to prevent the development of SCC.

Squamous cell carcinoma of the upper urinary tract: clinical characteristics, treatment patterns, and survival outcomes in the National Cancer Database

PURPOSE

We sought to investigate the disease characteristics, treatment patterns, and survival outcomes of upper urinary tract squamous cell carcinoma (UT-SCC) using the National Cancer Database (NCDB).

METHODS

The NCDB was queried for UT-SCC patients from 2004 to 2020. Patients with upper tract urothelial carcinoma (UTUC) were also identified for comparison with UT-SCC. Baseline characteristics were compared between UT-SCC and UTUC patients. Kaplan-Meier analysis assessed stage-based differences in median overall survival (mOS) between 1:4 propensity-matched cohorts of UT-SCC and UTUC patients. Predictors of mortality were assessed via multivariate cox regression.

RESULTS

644 cases of UT-SCC and 55,994 cases of UTUC were identified. Compared to UTUC, UT-SCC patients were more likely to have a higher TNM stage, lymphovascular invasion, and positive surgical margins. UT-SCC demonstrated a comparable mOS to UTUC for non-metastatic T1-T2 disease (74.84 vs. 106.38 months, p = 0.353) and metastatic disease (5.62 vs. 7.16 months, p = 0.058). However, UT-SCC carried a poorer prognosis for carcinoma in situ (45.14 vs. 69.32 months, p = 0.032) and non-metastatic T3-T4 disease (13.63 vs. 31.93 months, p < 0.001). Moreover, we found increasing T stage, metastatic disease, and positive surgical margins to be significant predictors of UT-SCC mortality. Lastly, we found that surgery does not confer a survival benefit over other management strategies for metastatic UT-SCC.

CONCLUSIONS

UT-SCC is a rare, aggressive malignancy that typically presents with a more advanced stage than UTUC. Surgical margin status may represent one of the most salient predictors of UT-SCC mortality. Further studies are needed to best define treatment strategy for this uncommon malignancy.

Primary Squamous Cell Carcinoma of the Renal Pelvis: A Rare Complication of Xanthogranulomatous Pyelonephritis

Xanthogranulomatous pyelonephritis is a rare disease resulting from chronic inflammation and infection of the renal parenchyma. It usually arises as a consequence of obstructive chronic pyelonephritis. Primary squamous cell carcinoma of the renal pelvis is a distinct pathology, very rare in clinical practice, with a well-established association with xanthogranulomatous pyelonephritis. The authors present the case of a 57-year-old woman with chronic pyelonephritis containing xanthogranulomatous features. Subsequent workup revealed a concomitant, unsuspected, primary squamous cell carcinoma of the renal pelvis. With this case, the authors intend to emphasize and reinforce the need to be alert to an uncommon association between two rare diseases due to its diagnostic, therapeutic, and prognostic implications.

Primary Renal Squamous Cell Carcinoma in Native Polycystic Kidney and Ureter 16 Years After Living Donor Kidney Transplant

We describe a case of a 55-year-old woman with polycystic kidney disease who received a living donor kidney transplant 16 years earlier and was on immunosuppressive therapy with satisfactory renal function. The donor was her mother. The patient presented with flank pain on the right side and macrohematuria, and noncontrast computed tomography and magnetic resonance imaging led to the diagnosis of tumors in the remaining right native polycystic kidney and ureter, as well as secondary retroperitoneal dissemination. We performed right radical nephrectomy and ureterectomy with extirpation of 2 metastases; the left native kidney remained intact. Histology showed squamous metaplastic changes and invasive epithelial neoplasm in the lumen of the renal pelvis and ureter with extensive squamous differentiation positive for nuclear p63 as squamous cell immunohistochemical marker. After surgery, an immunosuppressive therapy with methylprednisolone was administered, without calcineurin inhibitors and mycophenolate mofetil. Twelve months later the patient was still alive, with a glomerular filtration rate of 29 mL/min. Needs remain for further treatment modalities in patients with primary squamous cell carcinoma in nonfunctioning kidneys and improvements in imaging technique accuracy.

Primary squamous cell carcinoma of renal parenchyma: Case report and review of literature

Primary squamous cell carcinoma (SCC) of renal parenchyma is very rare and until now only a few cases have been reported. We report a unique SCC case in terms of aggressive nature and metastatic pattern. Renal rubber consistency and pasty keratin secretions were important findings in our patient. The patient underwent radical nephrectomy and lymphadenectomy and received 4 cycles of chemotherapy with cisplatin and gemcitabine. Eight month later, she succumbed the disease after developing ovary metastasis and not responding to chemotherapy. Also, our study showed that SCC may be present in pyelonephritic kidneys without a specific radiologic finding.

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.

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.

Urothelial and Squamous Cell Carcinoma of Renal Pelvis - A Rare Case Report

Primary malignant tumors of the renal pelvis are relatively rare. Urothelial carcinoma of renal pelvis accounts for 7% of all renal neoplasms, with Squamous Cell Carcinoma (SCC) forming a very small percentage of these cases. Urothelial and SCC of renal pelvis is still a rarer entity. This malignancy of the renal pelvis lacks the characteristic presentation of common renal cell carcinoma and usually presents at an advanced disease stage. We report a case of urothelial and SCC of renal pelvis in a 61-year-old male who presented with non-specific clinical complaints like dysuria and right flank pain.

The Forgotten Complication of Recurrent Nephrolithiasis: "Squamous Cell Carcinoma of the Renal Pelvis"-A Case and Review of the Literature

Squamous cell carcinoma (SCC) of the renal pelvis is an aggressive tumor with insidious onset of unspecific symptoms and advanced stages at diagnosis. It is a rare entity, accounting for 0.5–8% of renal tumors. In this paper, we describe the case of a patient with a history of recurrent nephrolithiasis that presented with an aggressive form of SCC of the renal pelvis with rapid relapse after resection.

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.

Incidence of renal carcinoma in non-functioning kidney due to renal pelvic stone disease

The objective of This study was to report our pathological findings in nephrectomy specimens from patients treated for non-functioning hydronephrotic kidney due to renal pelvic stone disease. A total of 97 patients who underwent nephrectomy for non-functioning hydronephrotic kidneys between January, 2011 and June, 2014 were retrospectively reviewed. A non-functioning kidney was defined as one having paper-thin parenchyma on urinary ultrasound or computed tomography, exhibiting no contrast visualization in the collecting duct system on intravenous urography and having a split renal function of <10% on nuclear renal function studies. Following pathological evaluation, 9 patients were diagnosed with xanthogranulomatous pyelonephritis, 9 with malignant tumors and 79 with chronic pyelonephritis. Of the patients with chronic pyelonephritis, 2 also had renal adenomas. The malignant tumors included 3 transitional cell carcinomas (TCC), 2 squamous cell carcinomas (SCC), 3 renal cell carcinomas (RCC) (1 sarcomatoid, 1 papillary and 1 clear cell RCC), whereas 1 patient had concurrent RCC and TCC. In conclusion, non-functioning kidneys, particularly those with kidney stones, should be managed as possible malignancies, due to the higher incidence of malignant tumors in such patients compared with the normal population.