Squamous cell carcinoma of the renal pelvis presenting as an integumentary neoplasm of the flank: A case report

Primary squamous cell carcinoma of the renal pelvis presenting with severe hydronephrosis: A rare case report

INTRODUCTION AND IMPORTANCE

Primary squamous cell carcinoma of the renal pelvis is a rare malignancy, accounting for fewer than 1 % of all kidney tumors. This form of cancer normally develops in the urinary tract's transitional epithelium, and its presence in the renal pelvis is extremely rare.

CASE PRESENTATION

In this report, we discuss the clinical and pathological aspects of a patient with primary squamous cell carcinoma of the renal pelvis. The patient, a 58-year-old man, had flank discomfort associated with burning micturition. A right nephrectomy was done after imaging investigations indicated right kidney hydronephrosis. The diagnosis of primary squamous cell carcinoma was confirmed by pathological investigation of the specimen. The patient has received 4cycles of chemotherapy with cisplatin and gemcitabine. One month later, the patient was referred for a metastatic mass in the chest wall.

CLINICAL DISCUSSION

Because of the tumor's rarity, diagnosis and therapy are difficult. This case report emphasizes the significance of including primary squamous cell carcinoma in the differential diagnosis of renal pelvic tumors, especially in individuals with risk factors such as smoking and chronic renal calculi.

CONCLUSION

Renal pelvis squamous cell carcinoma is a rare, aggressive, high-grade tumor with a poor prognosis. Chronic irritation plays a substantial role in the process. Thus, patients with a history of urolithiasis should be monitored closely.

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.

Advanced Renal Pelvic Carcinoma Revealed after Treatment of a Staghorn Calculus by Endoscopic Combined Intrarenal Surgery

Renal pelvis carcinoma associated with staghorn calculus is a clinically rare condition. A 66-year-old man presented with flank pain due to an 8 cm complete staghorn calculus. We performed three lithotomies using endoscopic combined intrarenal surgery and carried out intraoperative biopsy. Histopathological examinations revealed a keratinized lesion. One month later, contrast-enhanced computed tomography showed an advanced renal pelvis carcinoma. These findings demonstrate that even an intraoperative biopsy may be insufficient to diagnose a renal pelvis carcinoma associated with a staghorn calculus. The possibility of RPCa developing when treating a long-standing staghorn calculus should therefore be kept in mind.