Cell Carcinoma Of Renal Pelvis Research Articles

Laparoscopic Heminephrectomy in Horseshoe kidney: single-center experience of four cases

BackgroundHorseshoe kidney (HSK) is the most common congenital fusion anomaly and found in 1 in 400 of the general population (Grainger et al. in Ir Med J 76:315–317, 1983 Jul). Impaired drainage due to anomalous anatomy leads to ureteric obstruction resulting in hydronephrosis and nonfunctioning kidney.Conventionally heminephrectomy is done by open technique; however, in the era of minimally invasive surgery, laparoscopic heminephrectomy in HSK has been described. Kidney location, aberrant vasculature and isthmus division are the most common obstacle encountered by the operating surgeon. Here we report our single-center experience in laparoscopic heminephrectomy in four patients with HSK.MethodsRetrospective data were analyzed for four cases of laparoscopic heminephrectomy for nonfunctioning moiety in HSK operated between 2012 and 2020. Of these four patients, one case was converted to open approach in view of intra-operative bleeding. Computed tomography urogram (CTU) was done pre-operatively in all patients. Laparoscopic surgery was performed via transperitoneal approach.ResultsThe mean age of the patients was 37 ± 5.38 years. Flank pain was noted in all cases while dysuria seen in two patients and one patient had fever. Mean operative time was 145 ± 26.92 min and estimated blood loss was 85 ± 55 ml. Various techniques for isthmectomy and lower pole resection were used including use of monopolar hook in laparoscopic suite, Ligasure and bipolar scissor in minimal invasive milieu and monopolar cautery in laparoscopic conversion to open procedure. Histopathological examination revealed chronic pyelonephritis in three cases and squamous cell carcinoma of renal pelvis in one case which was converted to open.ConclusionsLaparoscopic heminephrectomy in HSK is doable. Preoperative CT urography along with CT angiography may provide important anatomical and vascular information which reduces intra-operative risks of vascular injury or calyceal entry. Vascular control of isthmus and transection of dilated and thinned out lower pole with cauterization of pelvicalyceal mucosa will provide uneventful surgical course.

Primary squamous cell carcinoma of renal pelvis and kidney- Sole diagnosis by histopathology

Primary Squamous cell carcinoma of the renal pelvis is rare and accounts to only 0.5- 0.8 % of malignant renal tumours having poor prognosis. Chronic irritation, inflammation and infection induce the pathogenesis of this malignancy. A 53 year old male patient, presented with left flank pain since one month. On radiological investigation, his CT revealed atrophic shrunken left kidney measuring 7.9x5.2cms showing significant parenchymal thinning and complete loss of corticomedullary differentiation. A left upper ureteric calculus is seen measuring 7.5 mm with significant left renal hydronephrosis.Clinically, it was diagnosed as Xanthogranulomatous Pyelonephritis. Grossly the radical nephrectomy specimen measures 10.5x5.5x3.5cm. External surface is irregular & bosselated. On Cut surface renal architecture is effaced by necrotic mass measuring 9.5x5.0x3.0 cm involving pelvic ureter and most of renal parenchyma.Hematoxylin and eosin stained tissue revealed characteristic feature such as keratin pearls and intracellular bridges seen, rendering the diagnosis of well-differentiated keratinising squmaous cell carcinoma seen with 40% tumour necrosis associated with Keratinizing Squamous Dysplasia. In the present case, obstructive uropathy has triggered the event of malignancy. The radiologic differential diagnosis includes primary and secondary renal neoplasms and xanthogranulomatous pyelonephritis associated with renal calculi. XGP is commonly associated with lithiasis however, rarely causes keratinizing squamous metaplasia and its manifestations closely mimic renal neoplasm, leading to misdiagnosis of malignancy.The prognosis is dismal with a 5-year survival rate of <10%. CT and MRI play a crucial role in diagnosis and staging of these tumors, though histology always remains confirmatory and diagnostic.

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.

Transitional Cell Carcinoma in Pelvis of a Double Moiety Kidney- A Rare Presentation

Neoplasia of the renal pelvis in duplex kidneys is extremely rare, especially in complete renal ureteral duplex cases. A 46-year-old aged male patient had presented with intermittent haematuria for the last seven months. A mildly enhancing well-defined, lobulated mass arising from the pelvis of lower moiety of right kidney was found on evaluation. Confirmatory findings of a renal pelvic malignancy couldn’t be obtained. Infective condition like pyelonephritis couldn’t be excluded. To clear the diagnostic dilemma, flexible ureteroscopy was done which revealed the renal pelvic malignancy. Right lap assisted radical nephroureterectomy was done. Histopathology was suggestive of transitional cell carcinoma. The increased incidence of chronic infection, obstruction and stone formation may be instrumental in producing a higher incidence of renal pelvic tumours in patients with anomalous kidney. Diagnosing a neoplasia originating from a duplex kidney is difficult and often a multiple battery of investigations like intravenous pyelogram, ultrasonography and rigid ureteroscopy may not be useful. Considering the fact that tumour recurrence is high in the ureteric stump after local resection, a total nephroureterectomy seems to be a better treatment choice. Flexible ureteroscope might be the saviour in such doubtful clinical situations to confirm our diagnosis beyond doubt. Partial nephrectomy cannot be recommended unless long-term follow-up reports of such cases are available.

A unique case of transitional cell carcinoma of renal pelvis in a patient with Lynch syndrome

A unique case of transitional cell carcinoma of renal pelvis in a patient with Lynch syndrome

Imaging biomarkers based on multiphase CT data in differentiation of renal cell carcinoma

Background. Renal-cell carcinoma (RCC) is one of 10 mostly widely spread malignant tumors in the world. Recently scientists focused on investigation of new imaging biomarkers of RCC based on USG, CT, MRI and radionuclide examinations data in order to increase efficiency of current pathology diagnostics. The goal of this study was to evaluate an efficiency of application of the novel biomarkers based on multiphase CT in differential diagnostics of RCC. Materials and methods. In total 120 patients with solid renal tumors >4 cm in greatest dimension in whom nephrectomy followed by pathological analysis were enrolled into this retrospective study: 84 (70,0%) with RCC, 14 (11,67%) with transitional cell carcinoma of renal pelvis and 22 (18,33%) with benign renal tumors. We analyzed and compared pathologic and multiphase CT data. Results. Using of signal intensity with threshold 54,80 HU allowed to differentiate RCC from other renal tumors with sensitivity and specificity accordingly 98,8% and 69,4% (AUC=0,844, 95% CI=0,746–0,942, р<0,001) on excretory CT images. Differentiation of RCC and benign renal tumors using signal intensity with threshold of 61,84 HU demonstrated 79,8% sensitivity and 63,6% specificity (AUC=0,745, 95% CІ=0,599–0,891, р<0,001) on excretory CT images. Differentiation of conventional RCC histologic subtype from non-conventional using signal intensity of nephrographic CT images with threshold 79,39 HU was possible with 71,7% specificity and 54,8% sensitivity (AUC=0,718, 95% CІ=0610–0,826, р=0,001). Identification of papillary and chromophobe subtypes as well as Fuhrman grades of clear-cell RCC was also possible. Conclusions. Application of radiodensity of tumor measured using multiphase CT as diagnostic imaging biomarker of solid RCC is valuable clinical tool for differentiation of current pathology, its histologic subtypes and Fuhrman grades. The drawback of the method is relatively high radiation exposure of the patient.

Primary Squamous Cell Carcinoma of Renal Pelvis Associated with Staghorn Calculi Masquerading as Xanthogranulomatous Pyelonephritis

Primary Squamous Cell Carcinoma of Renal Pelvis Associated with Staghorn Calculi Masquerading as Xanthogranulomatous Pyelonephritis

Squamous cell carcinoma of renal pelvis presenting as pyelo-entero-cutaneous fistula: Case report and review of literature

Squamous cell carcinoma (SCC) of renal pelvis is a subtle tumor constituting only about 0.7% to 7% of all renal malignancies. Out of various aetiologies proposed, the most pertinent is long standing irritation due to calculi and infection. Pyelo-entero-cutaneous fistula is a rare but serious condition mostly secondary to iatrogenic injury occurring during per-cutaneous renal surgeries.We report a rare case of Squamous cell carcinoma of the renal pelvis presenting as Pyelo-entero-Cutaneous Fistula. The diagnosis of SCC of renal pelvis was made on post surgery pathological examination.

Prognosis and treatment of primary urinary tract small cell carcinoma

Objective To investigate the clinicopathological features, treatment modalities, and prognostic factors for survival in patients with urinary tract small cell carcinoma( UT-SCC). Methods A total of 25 patients treated from June 2000 to December 2014 were included in the retrospective study. The data included age, gender, primary tumors origins, stage, treatment modalities, progression-free survival(PFS), overall survival(OS), pathology and immunohistochemistry. Of these cases, 22 were male, and the other was female, whose age was 45-79 years (mean age 67). 20 cases small cell carcinoma of bladder patients and 2 small cell carcinoma of prostate cancer patients were included. The number of small cell carcinoma in pelvis, ureter and retroperitoneal was 1 respectively. The patients with small cell carcinoma of the urinary tract were classified as disease and extensive disease. 17 bladder small cell carcinomas were limited disease and 3 cases were extensive disease; Prostate small cell carcinomas were both extensive disease; The small cell carcinomas in pelvis, ureter were limited disease; The small cell carcinoma in retroperitoneal was extensive disease. 10 bladder small cell carcinomas which were limited disease received radical cystectomy. 6 of 10 patients received etoposide and cisplatnum (EC). 4 of 10 patients received gemcitabine and cisplatnum (GC). 7 bladder small cell carcinomas patients who with limited disease refused to receive radical cystectomy in which 2 patients received TURBT and 5 patients received TURBT followed chemotherapy. Both prostate small cell carcinomas received chemoradiotherapy. 2 small cell carcinomas in upper urinary tract (pelvis and ureter) received radical nephroureterectomy with bladder cuff resection. The patient of retroperitoneal small cell carcinoma received percutaneous nephrostomy after biopsy. The progression-free survival (PFS) and overall survival (OS) of these patients are analyzed; the influence of TURBT with adjuvant chemotherapy and clinicopathologic characteristics were analyzed in median PFS and OS. PFS and OS were compared between groups as a function of time, using a Kaplan-Meier survival curve analysis and the log-rank significance test. All statistical tests were two-sided, and P values < 0.05 were considered statistically significant. Results 25 patients with a pathologic confirmation of UT-SCC, either by biopsy or surgery, were finally included. These patients were classified as pure UT-SCC (14) and Mixed UT-SCC (11). Mixed UT-SCC was defined as tumors containing both SCC and non-SCC components, regardless of the proportion of the latter. 13 cases were strongly positive and 3 cases were weakly positive in neuron specific enolase (NSE) level. 8 cases were strongly positive and 2 cases were weakly positive in CgA level. Patients with limited disease experienced a significant longer PFS and OS compared with extensive disease subjects (PFS 13.2 vs. 7.8 χ2=13.53 P<0.01; OS 27.2 vs. 12.7 χ2=19.88 P<0.01). Patients with bladder SCC showed a significantly higher median PFS and OS compared with patients with SCC of other parts of urinary tract (PFS 12.8 vs. 8.2 χ2=12.00, P=0.001; OS 26.3 vs. 13.2 χ2=14.45, P<0.01). The two different chemotherapy regimens (GC and EC) have no influence on survival (PFS: 16.3 vs.12.5, χ2=3.34, P=0.07; OS 29.5 vs.22.8, χ2=1.66, P=0.198). TURBT followed by adjuvant therapy have no influence on survival (PFS 14.5 vs.12.0 t=1.30 P=0.251; OS 24.5 vs. 28.4 t=0.50, P=0.636). Conclusions The primary tumors origins and stage may have influence on survival in patients with UT-SCC. Patients with bladder small cell carcinoma and limited disease experienced a longer survival. Key words: Urological neoplasms; Small cell carcinoma; Treatment; Prognosis

Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases.

Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute greatly to an early diagnosis and early treatment, both of which will significantly minimize the damage of, and markedly improve the prognosis of, renal pelvic SCC.

Disseminated tuberculosis in a patient with recurrent transitional cell carcinoma of renal pelvis and bladder following intravesical BCG therapy: A report of a rare case

Bacillus Calmette-Guerin (BCG) has been used as an intravesical instillation for nonmuscle invasive (superficial) bladder cancer for the last 3 decades. Although intravesical BCG therapy is well-tolerated by most of the patients, adverse reactions have also been reported which are usually local, benign, and self-limited. Systemic complications such as miliary tuberculosis (TB) are very rare with few documented reports in literature. We hereby report a rare case of disseminated TB in bilateral lungs, adrenal, cervical, mediastinal, and para-aortic lymph nodes in a patient with recurrent transitional cell carcinoma (TCC) of renal pelvis and urinary bladder. Peculiar feature of this case was the development of TB 2 years following last BCG instillation, which is unlike most of the cases in the literature where TB developed within few weeks of last dose of BCG.

Primary squamous cell carcinoma of kidney: a case report

Neoplasms of the kidney are most commonly adenocarcinomas. Squamous cell carcinoma of renal pelvis and ureter are very rare and account for 6-15% of all renal tumours. Very few such cases have been reported. Most are associated with calculus disease or hydronephrosis. Our case was a 44year old female having pain & lump in right flank since six months. Contrast CT abdomen showed an 8.8x8.8x6.4 cm renal upper pole mass with well-defined rounded calcification invading directly into the liver. There was no calculus or hydronephrosis. Ultrasound guided tru-cut biopsy was inconclusive, showing only dysplastic cells. On exploration, the mass was found to be arising from postero-superior pole of right kidney, with direct invasion into the liver. A nephroureterectomy with wedge resection of liver was performed. Histopathology of the specimen showed well differentiated squamous cell carcinoma of renal pelvis extending into liver.

Primary squamous cell carcinoma of kidney: Report of two cases

Primary squamous cell carcinoma of renal pelvis is rare clinical entity with only few cases have been reported in the literature. It is usually associated with long standing renal calculi. Insidious onset of symptom and inconclusive clinical and radiological features leads to locally advanced or metastatic disease at presentation; resulting in poor prognosis. Here we are reporting two cases of squamous cell carcinoma of kidney having renal calculi to highlight its clinical presentation and to document the association of squamous cell carcinoma in longstanding nephrolithiasis due to its rarity.

Expression and clinical significance of transcription factor Sp1 in uroepithelial cell carcinoma of renal pelvis

Objective To investigate the expression and clinical significance of transcription factor Sp1 in uroepithelial cell carcinoma (UCC) of renal pelvis.Methods The immunohistochemical PV-9000 method was used to study the expression level of Sp1 protein in 43 cases of UCC and 11 cases of normal mucosa in renal pelvis.Results The positive expression rate of Sp1 protein in UCC and normal mucosa of renal pelvis was 74.4％ and 0 (P ＜ 0.05),and that in low-grade and high-grade UCC of renal pelvis was 59.1％ and 90.5％ (P ＜ 0.05),that in superficial and infiltrated UCC of renal pelvis was 58.3％ and 94.7％ (P ＜ 0.05),respectively.Conclusion The positive expression of Sp1 protein is directly related to the histological grades and T stages of UCC in renal pelvis,suggesting Sp1 may participate in the carcinogenesis and progression of UCC. Key words: Renal pelvis; Uroepithelial cell carcinoma; Transcription factor Sp1

Detection of Genomic Instability in Renal Cancer by Random Amplified Polymorphic DNA Analysis from Urine Sample as a Non-invasive Method: Potential Use in Diagnosis

The study applied random amplified polymorphic DNA (RAPD) analysis including PCR technique in detection of genomic instability of renal cancer from urine samples as an early detective and a noninvasive method. DNAs extracted, using manual method, from exfoliated cells in urine of 52 renal cancer patients. All yielded DNAs were amplified with the same 10-base pair random primer (BioA-09) with GC rich sequence (5’-GGGTAACGCC-3’). PCR products from RAPD analysis were electrophoretically separated in agarose gels and banding profiles were visualized by ethidium bromide staining and viewed under ultraviolet light. Genomic alteration has been shown and included the disappearing of normal bands and appearing of new bands related to the tumor. The correlation between the genomic alteration and the histopathological types was assessed by using the X 2 test. Bands with molecular sizes 180 (X 2 = 13.15, p <0.001), 250 (X 2 = 9.524, p = 0.002), and 1250(X 2 = 5.357, p = 0.021) bp can be utilized as molecular markers for conventional renal cell carcinoma in addition to 1700 bp utilized as molecular marker for transitional cell carcinoma of renal pelvis (P = 0.005). Also there is an association between the presence of 500 bp and renal tumor as general (90.4%). The results of current investigation support the availability of using of RAPD-PCR analysis for screening of specific molecular markers by using Bio-A09 primer. These markers might be useful in diagnosis of renal cancer types and inspecting the tumor development.

About a Case Report of Giant Hydronephrosis

Introduction. Our objective is to report a case of an infrequent entity as the giant hydronephrosis. Case Report. We report the case of an 82-syear-old male referred for a poor general condition. A radiological study revealed a great left hydronephrosis secondary to an urothelial carcinoma. The patient died due to his poor general condition. A histological diagnosis revealed a transitional cell carcinoma of renal pelvis and ureter and atrophic renal parenchyma. Conclusion. Giant hydronephrosis represents a very often entity to be taken into account in cases with big cystic abdominal masses in absence of unilateral or bilateral kidney. Simple nephrectomy is the treatment of choice in most cases. Nevertheless, in cases of nonsubsidiary surgery, percutaneous drainage may be necessary.

Cutaneous Metastases From Transitional Cell Carcinoma of the Renal Pelvis: A Case Report

A 73-year-old female patient presented with left back pain. Computed tomography showed a mass around the left renal hilum and subcutaneous masses in her abdomen. She was referred to our hospital. Retrograde pyelography showed an upper urinary tract obstruction. Urinary cytology of the ureter was negative. Biopsy of the subcutaneous mass was performed, and the pathological findings showed transitional cell carcinoma. She was diagnosed with transitional cell carcinoma of the left renal pelvis with metastasis to the skin (cT4N0M1). She received combination chemotherapy, but the size of her skin lesions was increasing. Three months after admission, she died. Metastasis to the skin from the renal pelvis is very rare; only four cases have been reported. Our case is the first report on transitional cell carcinoma of the renal pelvic metastasizing to only the skin at presentation. We herein summarize this rare metastasis and discuss its clinical features and therapeutic management. doi: http://dx.doi.org/10.4021/wjnu45w

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

Squamous cell carcinoma (SCC) of urinary tract is a rarely encountered tumor. The incidence of this tumor is 1.4 per cent of all renal malignancies (1). We present a case of 52 years male with squamous cell carcinoma of renal pelvis, presenting as chronic pyelonephritis transforming the kidney into non-functioning multicystic cavitatory mass without any renal calculi. The case highlights the rarity of tumor in absence of calculi or any other predisposing factor. Moreover, histology of resected specimen detected features of SCC giving importance to careful and exhaustive assessment of specimen and of histologic sections, when there is no suspicion of malignancy clinically.

Clinical analysis ofsquamous cell carcinoma of renal pelvis

：Objective To review thediagnosis and treatment of squamous cell carcinoma of renal pelvis. Methods The clinicaldata from October 1991 to May 2009 of eight cases of squamous cell carcinoma of renalpelvis were reviewed and analyzed retrospectively. The symptoms of the patients werehematuria (eight cases), pain (seven cases) and abdominal mass (one case). All patientsunderwent B-ultrasound and IVU examination and four cases underwent CT scan. Three caseswere diagnosed as having a tumor before surgery. Five cases were diagnosed as renalcalculus, two of the five cases were diagnosed by intraoperative frozen section. Radicalnephroureterectomy were performed in four cases, nephrectomy in three cases and palliativeresection in one case. Results Histological classification revealed that six cases weremoderately differentiated, one case was well differentiated and one case was poorlydifferentiated. Two cases had stage pT1/pT2 and six cases had stage pT3/pT4. 2 cases hadregional lymph nodes metastasis. Seven cases were followed-up. All patients died of tumorrecurrence or metastasis. The median tumor specific survive time was six months (rangefrom two months to 42 months). Conclusions Squamous cell carcinoma of renal pelvis isoften occurs concurrently with urolithiasis which could lead to difficulty in diagnosebefore operation. As the most of the patients were diagnosed with advanced stage disease,squamous cell carcinoma of renal pelvis tended to early recurrence and metastasis and theprognosis was very poor.