An 82-year-old man presented to the urology department with a 1-week history of intermittent
gross hematuria. Ultrasonography of the urinary system revealed a left upper pole
renal tumor. Computed tomography urography imaging (Fig. 1A-D) demonstrated an irregular tumor within the superior pole of the left kidney,
with mild to moderate enhancement and internal multiple round stones. Volume rendering
(Fig. 1E) showed a filling defect of the left renal pelvis and upper pole accompanied with
extensive stones. Laboratory evaluation revealed the following: C-reactive protein,
23.94 mg/L (reference range, 0 to 10 mg/L); urine red blood cell count, 5.35 (reference
range, 0 to 3); carcinoembryonic antigen, 18.39 ng/mL (reference range, 0 to 5 ng/mL);
cancer antigen 199, 33.98 kU/L (reference range, 0 to 30 kU/L); and squamous cell
carcinoma antigen, 41.07 μg/L (reference range, 0 to 2.7 μg/L). The patient underwent
left radical nephrectomy. A gross examination (Fig. 1F) revealed multiple regular pebble-shaped stones in the center of the grayish white
renal tumor. Pathological examination (Fig. 1G) confirmed squamous cell carcinoma, which had migrated with the mucosa of the renal
pelvis, with the following immunohistochemistry results: CK5/6 (+) (Fig. 1H), P40 (+), PAX-8 (-), CK20 (-), CK7 (-), GATA3-3 (-), Ki-67 (60%+). However, 10
months after the operation, widespread metastases occurred involving the retroperitoneal
space, pelvic cavity, both lungs, and left subclavian region.
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References
- Squamous cell carcinoma of the renal pelvis associated with kidney stones: radiologic imaging features with gross and histopathological correlation.J Clin Imaging Sci. 2013; 3: 14
- Renal pyelocalyceal squamous cell carcinoma.Mayo Clin Proc. 2017; 92: 1603-1604
- Squamous cell carcinoma of the renal pelvis associated with kidney stones: a case report.Med Oncol. 2011; 28: S392-S394
Article info
Publication history
Published online: December 18, 2022
Accepted:
December 15,
2022
Received:
August 31,
2022
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.