Pelvic Carcinoma Research Articles

Rare primary lymphoepithelioma-like carcinoma of the renal pelvis.

Lymphoepithelioma-like carcinoma (LELC) is a rare, malignant epithelial tumour which can arise within the upper urinary tract. This letter adds to a previous systematic review and cumulative analysis of 28 published upper urinary tract-LELC cases which provided insight into this disease; however, the current evidence does not provide clinicians with clear guidelines due to its rarity. Therefore, the aim was to report a new case of renal pelvis LELC presented in our hospital. In this instance, we were able to report treatment experience and long-term follow-up results. This patient presented with hypertension and haemturia which initiated further investigation. While ultrasound identified an hypechoic mass, no malignant cells were detected using cytological testing. Abdominal magnetic resonance imaging identified a slightly enhanced mass in the left renal pelvis with no evidence of lymph node metastasis. Ureteroscopic tumor biopsy suggested the existence of urothelial carcinoma, hence, laparoscopic radical left nephroureterectomy with bladder cuff excision was performed. Through patient-practitioner consultations, we decided to adopt a "watch and wait" approach after radical nephroureterectomy rather than administering chemotherapy. Although, we would encourage clinicians to record and publish cases to garner insight into this type of malignant disease.

Squamous cell carcinoma of the renal pelvis with an associated double ureters-rare case report

Squamous cell carcinoma is rare in the renal pelvis and kidney than in the lower urinary tract. Mostly it is associated with renal stone. Here a case report of a 72-year-old male who presented with renal mass was reported. Radical nephrectomy was done, shows a tumor involves the middle pole and extends into the renal pelvis. The hilar surface shows the presence of double ureters. Histopathological examination showed a well-differentiated squamous cell carcinoma in the renal pelvis and one of the ureter. Tumor involves more than 50% of the renal parenchyma. There is also squamous metaplasia of lining epithelium of smaller length ureter seen. No evidence of urothelial dysplasia noted in the renal pelvis and both the ureters. Adjacent renal parenchyma, glomeruli show focal segmental glomerulosclerosis with mild Interstitial fibrosis and tubular atrophy(IFTA). Medium size vessels show intimal thickening and mucoid change. The final diagnosis of squamous cell carcinoma of the renal pelvis and smaller ureter infiltrating renal parenchyma, possibly secondary to the risk factor of the double ureter.

Ung thư biểu mô tế bào vảy của đài bể thận (rscc): thông báo 1 trường hợp và hồi cứu y văn

SQUAMOUS CELL CARCINOMA (SCC) OF THE RENAL PELVIS: A CASE REPORT AND REVIEW OF LITERATURE Background: SCC of Renal pelvis are rare in clinical practice and patholoyl. We report a case with clinicopathological correlation of SCC in Hospital C Da Nang The purpose of this case is to demonstrate on unusual and aggressive of SCC .The discusses the clinical and and radiological features. Methods :We review the clinical and pathological record of a case RSCC in retrospective of nephrectomy specimens and follow up the patient from Oct/2018 to Jan/2019 and approprivate literatures Case reportA 78 years old malepresented with history of renal stone operation ten years ago.The patient admitted with flank,abdominal pain and hematuria.Family history and physical examination were within normal limits Ultrasound examination of abdomen showed left renal calculi, KUB and UIV which reveals only calculi and hydronephrosisAbdominal CT reveals a left renal pelvis mass, calculis and large lymph nodes. The patient underwent a left radical nephrectomy without complications Histopathological examination revealed features of well – differentiated squamous cell carcinoma of renal with extensive involvement of renal parenchyma and metastasis to lymph nodes.Due to aggressive nature of these tumour patient develop locally recurrence and disseminated metastatic disease. The patients was dead four month after pathologic diagnosis. Primary SCC of renal pelvis is rare, which represents only 0.5 to 15 % of malignant renal tumor. Few such cases have been reported.Nephrolithiasis, especially formation of staghorn stone was accepted as a main carcinogenic risk factor SCC. Chronic irritation, inflammation and infection are believed to induce reactive change in the urothelium and leads to neoplasia via metaplasia and leucoplasia. Initial diagnosis of SCC is based on histopathological examination. The histopathology is the hallmark of diagnosis because of lack of characteristic clinical and imaging features. Most of these SCC are moderately or presented with advance stage. The current primary treatment of renal SCC is nephrectomy, adjuvant chemotherapy or radiotherapy indicated in metastatic disease. However, it is highly aggressive unfavorable outcome, suggesting very poor prognosis, with a median survival of 3.5 months in cases of metastatic dissemination; 7 months post operatively and a dismal 5 years survival rate 7.7% Conclusion: primary SCC of renal pelvis is a rare aggressive tumor with poor prognosis. The patient with newer imagingteachnologies for early detaction of the tumor that may lead to better outcome for the patients Histopathology is the hallmark of diagnosis which is usually made after surgical resection Keyword: Squamous cell carcinoma of renal pelvis.

Transitional cell carcinoma of the renal pelvis masquerading as renal tuberculosis

We report a case of transitional cell carcinoma of the right renal pelvis mimicking the signs, symptoms and radiological findings of renal tuberculosis (TB). She had been diagnosed initially for urinary tract infection and radiological diagnosis initially was more towards renal TB and urine cytology and cultures were normal. Specific investigations for tuberculosis all showed negative results. But as neoplasia could not be ruled out by ureterorenoscopy due to presence of multiple ureteric strictures, decision was taken for an exploratory surgery. During surgery it was found that there was a tumour in the upper pole of kidney involving the renal pelvis and was found to be papillary transitional cell carcinoma on histopathological examination.

FGFR2/3 genomic alterations (GA) in cell-free (cf)DNA from patients (pts) with advanced urothelial carcinoma (aUC).

565 Background: Erdafitinib is approved in pts with aUC with relevant FGFR2/3 GA. BLC2001 trials in pts with activating FGFR2/3 mutations reported 40% ORR to erdafitinib (49% for those with single nucleotide variants [SNVs] and 16% with fusions), 39% stable disease rate, and potentially reduced response to anti-PD-L1. Genomic profiling with plasma cfDNA next-generation sequencing (NGS) is increasingly used to identify targetable GA in pts with advanced solid tumors and presents a minimally invasive option for identification of FGFR2/3 GA. Methods: Genomic data from the Guardant360 database were queried from clinical results released from 10/19/15 - 8/28/19 for clinical samples submitted with diagnoses of aUC or related diagnoses (e.g. bladder cancer, renal pelvis carcinoma). All assays included FGFR2/3 fusions and complete sequencing of all critical exons harboring sensitizing FGFR2/3 SNVs. Results: 1349 results from 1096 unique pts were identified. Somatic GA were identified in 1192 tests (88%) from 997 pts. Fusions and/or nonsynonymous SNVs in FGFR2/3 were identified in 201 pts (20%); 141 pts (14%) had at least one characterized activating FGFR2/3 GA. Of 34 pts (3.4%) with FGFR3 fusions, partners included TACC3 (32), JAKMIP1 (1), and TNIP2 (1). Overall, most SNVs identified in FGFR3 were predicted to be activating (103/125, 82%) whereas in FGFR2 most were variants of uncertain significance (VUS; 62/72, 86%). Of 89 unique variants (59 in FGFR2, 30 in FGFR3), 19 (21%) were activating mutations (7 in FGFR2, 12 in FGFR3). The most common activating SNVs in FGFR3 were S249C (58 pts), Y373C (20) and R248C (10), and in FGFR2 was N549K (4). VUS in both genes were individually uncommon (no VUS recurring in >3 pts). Median copy number-adjusted clonality of SNVs in FGFR3 was higher than those in FGFR2 (0.80 vs 0.20); this remained true when limiting to only characterized activating mutations (0.84 vs 0.17). Conclusions: cfDNA NGS analysis identifies fusions and a broad spectrum of SNVs in FGFR2/3, including heterogeneous subclonal mutations, at a rate similar to reported tissue testing. cfDNA is a minimally invasive option for pts with aUC to assess candidacy for erdafitinib and clinical trials.

Proposal of a new subcategory of the pT3 classification: Effects of tumor location and subclassification of renal pelvic pT3 to predict the prognosis of pelvic carcinoma more accurately than the current TNM classification.

455 Background: Whether pT3 urothelial carcinoma of the renal pelvis (UCRP) and urothelial carcinoma of the ureter (UCU) show the same prognosis or not remains controversial.This study aims to reveal whether the prognosis of pT3 UCRP shows similar to those of pT3 UCU. Methods: We retrospectively evaluated 954 patients who underwent nephroureterectomy between 1983 and 2017 at our institutions.None of the patients received neoadjuvant therapy.All HE slides for each patient were reviewed by a single genitourinary pathologist (TT).pT3 UCRP was subdivided pT3a (urothelial carcinomas that extend only to the renal medulla) and pT3b (urothelial carcinomas that extend to the renal cortex and/or peripelvic adipose tissue) according to the criteria previously we proposed.Fine and Gray model was developed to predict the reccurence-free survival (RFS) and cancer-specific survival (CSS). Results: Overall, 954 patients were eligible for this study, 493 of whom were pT3 with only renal pelvis and 461 of whom were pT3 with only ureter. A total of 202 cases were pT3 UCRP and 146 were pT3 UCU. The pT3 subclassification of UCRP resulted in 79 pT3a and 120 pT3b cases.No significant difference was found in the 5-yr RFS and 5-yr CSS between pT3a UCRP and pT2 UCRP and pT2 UCU. (RFS; pT3a UCRP vs pT2 UCRP: HR = 1.19 p = 0.74; pT3a UCRP vs pT2 UCU HR = 0.88, p = 0.72, CSS;pT3a UCRP vs. pT2 UCRP: HR = 0.69; p = 0.56; pT3a UCRP vs. pT2 UCU: HR = 0.66, p = 0.31) The RFS rate was significantly higher in the pT3a UCRP than that of pT3b, (pT3a vs pT3b: HR = 2.59, p = 0.0038) and so was the CSS rate. (pT3a vs. pT3b: HR = 3.1 p = 0.001) In fine and gray model analysis for RFS, pT stage, lymph node metastasis, WHO/ISUP grade, lymphovascular invasion were independently associated with tumor recurrence, whereas pT stage, lymph node metastasis, operation method, histologic type, lymphovascular invasion, gross type, adjuvant chemotherapy were independently associated with cancer mortality. Conclusions: Subclassifying pT3 UCRP into pT3a and pT3b was useful in determining the prognosis of different patients.The pT3b UCRP showed similar outcome compared to those of UCU.

Upper Tract Transitional Carcinoma: An Array of Imaging Conundrum

Case report: We report a 38-year-old gentleman who presented with painless haematuria for 6-months duration. Contrast-enhanced CT renal revealed a large, calcified intrapelvic mass with calyceal extension confined within the right kidney with moderate pelvicalyceal dilatation but no evidence of synchronous lesion elsewhere. Histopathological analysis showed high grade urothelial carcinoma of the renal pelvis with invasion of the renal parenchyma. Upper tract urothelial carcinoma (UTUC) which was once thought similar to urothelial carcinoma of the bladder (UCB), is increasingly being recognized as a different entity. However, heterogenous array of imaging manifestations of UTUC is also increasingly being encountered and pose diagnostic challenges though UTUC is not as prevalent as UCB which is easier to diagnose. Despite distinctive features against renal cell carcinoma (RCC), UTUC may mimic numerous other renal pathology especially the benign ones hence imaging plays a pivotal role to ascertain the diagnosis. This disease is usually treated with radical nephroureterectomy with superadded neoadjuvant chemotherapy for high risk cases. Less invasive endoscopic resection is also offered in certain cases but stringent surveillance of the whole urinary tract as well as post-operative follow-up are mandatory.

Renal pelvic urothelial carcinoma in horse shoe kidney with recurrence in urinary bladder—a case report and adjuvant treatment review

Background: Horse shoe kidney is rare, rarer is urothelial carcinoma of renal pelvis in horse shoe kidney, but is more common than that in normal kidney. Radical nephroureterectomy with removal of a cuff of urinary bladder is the standard of treatment. Despite of complete surgery, there are loco-regional recurrences. Case Report: Presenting a case of 60-year male with gross hematuria of 2 months. On imaging found to have horse show kidney with right kidney upper pole mass, believing it to be renal cell carcinoma, nephrectomy was done. However, histopathology turned out to be low-grade urothelial carcinoma of pelvis. Patient had recurrence in left over ureteral stump and ureteric orifice after 10 months. Completion surgery followed by adjuvant intra-vesical bacille calmette guerin (BCG) was given and patient has no recurrence since past 2 years. Conclusion: Urothelial carcinoma of renal pelvis although rare, but it is three to four times more common than that in normal kidney due to chronic obstruction in horse shoe kidney. Due to multifocality of urothelial carcinoma of renal pelvis, gold standard treatment remains complete nephroureterectomy with removal of a cuff of urinary bladder. Post-operative locoregional recurrences are seen and judicious use of intravesical BCG, chemotherapy, and radiotherapy has shown to beneficial.

A case report of sarcomatoid carcinoma of the renal pelvis in elderly patient

肾盂肉瘤样癌是一种极为罕见的恶性肿瘤，目前国内外报道较少，本患者男，63岁，因双侧腰部疼痛不适2年，加重1月于2010年5月入院。入院诊断：双肾结石并双肾积水，尿路感染。经抗感染治疗后在全麻下行经皮肾镜左肾结石Ⅰ期钬激光碎石术。术中见左侧肾盂内大量乳头状新生物及灰白色坏死物质，行术中冰冻活检，提示尿路上皮癌，遂终止手术。首次手术1周后，于全麻下行后腹腔镜左侧肾盂癌根治术。术中因肾脏与周围组织粘连紧密，不易分离，遂改行开放手术，切除左肾及左输尿管，并在左输尿管入膀胱处行袖套状切除。术后病理诊断：左肾盂肉瘤样癌。建议患者术后转肿瘤科进一步治疗，但患者拒绝，出院后定期电话随访，随访至术后第10个月时患者死亡，死亡原因为肿瘤晚期恶病质。患者临床表现不典型，预后差。迄今为止我院仅收治1例。

HER2 Status in Molecular Subtypes of Urothelial Carcinoma of the Renal Pelvis and Ureter.

Erb-b2 receptor tyrosine kinase 2 (ERBB2, also known as HER2) gene amplification or protein overexpression occurs in certain types of urothelial carcinomas. Molecular pathologic classification of urinary bladder cancer using immunohistochemistry has identified basal and luminal subtypes with differing prognoses, but the HER2 status of these subtypes has not been investigated. In addition, research on urothelial carcinoma of the renal pelvis and ureter (UCRPU) has not progressed because of its rarity, though its prognosis is worse than that of bladder cancer. In this study, we evaluated the clinical significance of HER2 status in molecular subtypes of UCRPU. HER2 status (protein overexpression and/or gene amplification) and molecular subtyping were determined for 148 cases of UCRPU (83 and 65 cases in the renal pelvis and ureter, respectively), using immunohistochemistry and fluorescent in situ hybridization, and compared with clinicopathologic factors. Subtype analysis revealed that the cases were 46% basal and 54% luminal. HER2 protein overexpression and/or gene amplification was observed in 14% of UCRPU cases and was significantly more frequent in the luminal subtype than in the basal (22% vs. 4%; P= .0030). Univariate analysis showed that the overall survival of patients with HER2-positive UCRPU was significantly shorter than those with HER2-negative tumors. HER2 protein overexpression and gene amplification were specifically observed in the luminal subtype of UCRPU, suggesting that these cases may respond to HER2-targeted therapies like trastuzumab.

High-grade Pelvic Serous Carcinoma Within the Fallopian Tube Lumen: Real or Artifact?

Tumor cells are occasionally observed in the lumen in histologic sections of the fallopian tube from women with gynecologic cancer. There is some evidence that this finding may be important in endometrial cancer, but its significance is unknown in women with extrauterine pelvic serous carcinomas (tubo-ovarian high-grade serous carcinoma). Fallopian tube sections from 213 women with extrauterine pelvic serous carcinoma were reviewed, and luminal tumor cells were correlated with clinical and pathologic features. Intraluminal tumor cells were found in 84 patients (39%). The presence or absence of luminal tumor cells correlated significantly with serous tubal intraepithelial carcinoma (52% and 33%, respectively, P=0.004), tubal lymphatic invasion (32% and 12%, respectively, P=0.0002), and number of tube sections reviewed (6.6 and 4.9 for lumen-positive and lumen-negative cases, respectively, P=0.0056). There was no correlation with the presence of ascites, peritoneal cytopathologic findings, lymph node metastases, or FIGO stage. In the setting of pelvic serous carcinoma, a substantial portion of fallopian tube tissue is often distorted, fibrotic, and difficult to identify. Since the identification of luminal tumor cells, serous tubal intraepithelial carcinoma and tubal lymphatic invasion all depend on identification of fallopian tube tissue, these correlates with luminal tumor cells could be a result of a higher likelihood of their observation when tubal tissue can be more readily identified and may not necessarily reflect a biologically important phenomenon. It remains unclear whether and in what proportion this finding reflects an artifact of specimen handling.

An elderly man with progressive focal nodular hyperplasia

Patients with focal nodular hyperplasia (FNH) develop benign hepatocellular nodules. FNH most frequently occurs in young women. There are no reports of the onset of FNH in elderly men. We report a case of FNH in an elderly man, whose nodules increased in number and size. The patient underwent surgery for carcinoma of the left renal pelvis at 69 years of age; no liver masses were noted on yearly follow-up contrast-enhanced computed tomography (CECT). Ten years later, CECT revealed a hepatic mass, and magnetic resonance imaging suggested FNH. The nodules increased in number and size in subsequent follow-up examinations.

A CASE REPORT OF Xp11.2 TRANSLOCATION RENAL CELL CARTINOMA SUSPECTED RENAL PELVIC CARCINOMA

The patient was a 33-year-old female who visited the Department of Gastroenterology of this hospital after experiencing lower abdominal pain and nausea. The patient was referred to this department after suspicions of right kidney hemorrhage revealed by non-contrast computed tomography (CT). We also identified hematuria macroscopically, and contrast-enhanced CT scans revealed uneven deep staining in the upper right kidney during the early phase. Furthermore, by the late phase, we identified a 29-mm solid tumor with no staining. There was no clear pseudomembrane and no clear boundary with the kidney parenchyma. Additionally, there was no metastasis to the lymph nodes and other organs. Based on the above findings, we suspected renal parenchymal infiltration of right renal cell carcinoma (RCC) or right renal pelvic carcinoma. Since the patient was young, we considered the risk of the residual tumor and performed total nephroureterectomy and lymph node dissection with an enlarged view. The inside of the resected tumor specimen showed significant necrosis and hematoma spread, which had infiltrated the renal pelvis. Based on the characteristic histological findings and genetic results obtained using the fluorescence in situ hybridization (FISH) approach, we diagnosed the patient with Xp11.2 translocation RCC. No additional treatments were provided after surgery, and even now the patient is being followed-up through outpatient visits, but there has been no recurrence or new metastasis. There have only been a few reported cases of Xp11.2 translocation RCC; therefore, in many cases, treatments and follow-up duration according to the disease stage and disease prognosis have not been determined. In this study, we report a case of Xp11.2 translocation RCC experienced at our hospital, with additional literature considerations.

Data Set for the Reporting of Carcinoma of the Renal Pelvis and Ureter-Nephroureterectomy and Ureterectomy Specimens: Recommendations From the International Collaboration on Cancer Reporting (ICCR).

Cancer reporting guidelines have been developed and utilized in many countries throughout the world. The International Collaboration on Cancer Reporting (ICCR), through an alliance of colleges and other pathology organizations in Australasia, United Kingdom, Ireland, Europe, USA, and Canada, has developed comprehensive standardized data sets to provide for global usage and promote uniformity in cancer reporting. Structured reporting facilitates provision of all necessary information, which ensures accurate and comprehensive data collection, with the ultimate aim of improving cancer diagnostics and treatment. The data set for primary carcinoma of the renal pelvis and ureter treated with nephroureterectomy or ureterectomy had input from an expert panel of international uropathologists. This data set was based on current evidence-based practice and incorporated information from the 2016 fourth edition of the World Health Organization (WHO) Bluebook on tumors of the urinary and male genital systems and the 2017 American Joint Committee on Cancer (AJCC) TNM staging eighth edition. This protocol applies to both noninvasive and invasive carcinomas in these locations. Reporting elements are considered to be essential (required) or nonessential (recommended). Required elements include operative procedure, specimens submitted, tumor location, focality and size, histologic tumor type, subtype/variant of urothelial carcinoma, WHO grade, extent of invasion, presence or absence of vascular invasion, status of the resection margins and lymph nodes and pathologic stage. The data set provides a detailed template for the collection of data and it is anticipated that this will facilitate appropriate patient management with the potential to foster collaborative research internationally.

UP007 - Unexpected squamous cell carcinoma of the renal pelvis after percutaneous nephrolithotomy for large-long standing nephrolithiasis

UP007 - Unexpected squamous cell carcinoma of the renal pelvis after percutaneous nephrolithotomy for large-long standing nephrolithiasis

Suprapubic-assisted laparoendoscopic single-site surgery in nephroureterectomy A case series of 4 patients

Objective: To evaluate the feasibility and clinical value of suprapubic-assisted laparoendoscopic single-site surgery (SA-LESS) in nephroureterectomy using method of transvaginal natural orifice specimen extraction (NOSE) (SA-LESS+TV-NOSE NU). Methods: Four patients (three cases of renal pelvic carcinoma and one case of ureteral carcinoma) undergoing SA-LESS+TV-NOSE NU were enrolled between April 2015 and January 2016. After general anesthesia, the patients were placed in the lithotomy position with the affected side elevated by 60°. Two trocars were inserted at the medial margin of umbilicus, and the third one was inserted into abdominal cavity at the superior margin of pubic symphysis. The operation was performed under a direct vision with a 5.4 mm 0° flexible-tip laparoscope. Firstly, the distal ureter was isolated completely and blocked by a Hem-O-lok clip. Then, the laparoscopic nephrectomy was performed according to the standard method. Finally, the bladder cuff excision was executed and the incision was sutured. The intact specimen was placed inside a homemade bag and removed through the incision at posterior vaginal fornix. Results: All the procedures were successfully performed. The median operative time was 150 (range: 120 to 210) minutes, and the median estimated blood loss was 180 (range: 80 to 350) ml. No major perioperative complications occurred. The mean visual analogue score (VAS) of 24 hours and 48 hours after operation were 3.25 (range: 2 to 5) and 2.25 (range: 2 to 3). All the patients resumed ambulation on postoperative day 1. Pelvic drainage tube was removed on postoperative day 2-4. On postoperative day 7, urethral catheter was removed. The patients were discharged on postoperative day 7-9. During the follow-up of 20-29 months, the patient recovered well with no case of incisional hernia and pelvic, abdominal infections. The vaginal fornix incision healed well, and the umbilical and suprapubic puncture scars were not obvious. All the patients completed the patient-assessed acromegaly symptom questionnaire PASQ. The average PSAQ score of 3 months after surgery was 34.5. Three of them restarted their sex lives, with an average female sexual function index score of 16.0, which was not significantly different with that of preoperation (15.6). There was no tumor recurrence, metastasis and implantation in all cases. Conclusion: SA-LESS+TV-NOSE NU is safe and feasible for upper tract urothelial carcinoma with faster postoperative recovery, less pain, shorter hospitalization time, better cosmetic results, and does not cause negative effect on the female sexual function.

Squamous cell carcinoma of the kidney in a patient with staghorn calculi

Primary squamous cell carcinoma of the renal parenchyma is an extremely rare entity. The diagnosis of squamous cell carcinoma of the renal pelvis is usually unsuspected due to the rarity and inconclusive clinical and radiological features. The insidious onset of symptom and lack of any pathognomonic sign leads to delay in the diagnosis and subsequent treatment, resulting in grave prognosis for these patients. Here, we present a case of incidentally detected renal squamous cell carcinoma in a 71-year-old male with a staghorn calculus and Xanthogranulomatous pyelonephritis. The patient was treated with radical nephrectomy.

LOCALIZED AMYLOIDOSIS OF THE RENAL SINUS: A CASE REPORT

An 80-year-old man was accidentally diagnosed with a left renal pelvic tumor by computed tomography (CT), and visited our hospital. A tumorous lesion with an inhomogeneous contrast effect occupying the left renal pelvis was confirmed by the contrast-enhanced CT scan, and enlargement of multiple lymph nodes around the aorta and inferior vena cava was recognized. Urine cytology of the left renal pelvis was pseudo-positive. In the preoperative diagnosis of left renal pelvic carcinoma cT3N2M0, left nephroureterectomy and lymph node dissection were performed. Pathological findings revealed an amyloid tumor confined to the renal sinus and diagnosed as localized amyloidosis.

Маркеры стволовых клеток и их прогностические значения в уротелиальных карциномах мочевыделительной системы

Our aim was to carry out a comparative analysis of the expression of stem markers in the molecular subtypes of urothelial carcinomas, including ALDH1A1, CXCR4, CD24, CD82, CD105, CD133, NANOG, OCT4 and SOX-2. In addition, the relationship between the pattern of expression and the pathological features of the tumor was determined. Surgical specimens from 196 patients with a diagnosis of urothelial carcinoma of the renal pelvis and bladder were studied. Immunohistochemical study was performed on paraffin sections using the standard protocol. Antibodies against ALDH1A1, CD82, CD133, CXCR4, NANOG, OCT4, SOX2 ("Abcam"), CD24, CD105 ("Invitrogen"), CD31, CD34 ("Novocastra") were used. The stem cell markers used in the study were expressed in all molecular subtypes of urothelial carcinoma and there were no differences in frequency and intensity of expression between different phenotypes. However, the frequency and intensity of expression of the markers correlated with the tumor stage and the grade of cellular anaplasia. Our results confirm that cancer stem cells with basal phenotype are not an exclusive subpopulation in urothelial tumors. Other progenitor cells with the immunophenotype of intermediate and/or umbrella cells can serve as cancer stem cells. These features of the expression in cancer stem cell markers will allow to develop new approaches to the treatment of urothelial carcinomas.

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.