Bilateral nephrolithiasis and upper tract transitional cell carcinoma in horseshoe kidney

Abstract

Nephroureterectomy is currently the criterion-standard treatment for high-grade upper tract urothelial carcinoma. Current guidelines and expert opinions propose some exceptions to this approach based on patient characteristics, disease status, and function of the contralateral kidney. We present a rare case of a patient with horseshoe kidney, bilateral large nephrolithiasis, high-grade upper tract urothelial carcinoma in one moiety, and relative parenchymal thinning of the contralateral side. The patient was treated with a percutaneous, minimally invasive, nephron sparing approach. The patient also had intracollecting system instillations of gemcitabine and docetaxel. Minimally invasive percutaneous resection of high-grade upper tract urothelial carcinoma is a safe procedure in select cases. Current guidelines may not apply to all patients; unique scenarios with upper tract urothelial carcinoma may require personalized decision-making and treatment at specialized centers.