Urothelial carcinoma in a pyelocaliceal diverticulum discovered by magnetic resonance urography

Akatsuka, Jun; Suzuki, Yasutomo; Hamasaki, Tsutomu; Kimura, Go; Kondo, Yukihiro

doi:10.1590/s1677-5538.ibju.2014.02.19

Cited by 3 publications

(5 citation statements)

References 2 publications

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“…The data of gross and microscopic studies excluded the malignant nature of the kidney lesion, as well as other pathologies that it could imitate (first of all, teratoma-group lesions) ( 1 , 9 ). We observed extensive foci of squamous cell metaplasia without signs of cancer growth, in contrast to the previously reported cases ( 13 – 15 ).…”

Section: Discussioncontrasting

confidence: 99%

“…They can manifest with such symptoms as flank or loin pain, renal colic, urinary frequency, hematuria, infection or be asymptomatic. In addition, the diverticula contribute to nephrolithiasis, infection, hematuria and kidney failure, cause the compression of the surrounding tissues and facilitating the growth of malignant tumors ( 13 – 15 ).…”

Section: Introductionmentioning

confidence: 99%

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A Case Report of Calyceal Diverticulum: Differential Diagnosis for Organ-Preserving Operations

et al. 2021

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Calyceal diverticula and epidermal cysts are extremely rare kidney lesions with unknown etiology and pathogenesis. They have non-specific clinical and radiological picture. Despite the benign nature, sometimes these disorders mimic malignant tumors leading to unjustified nephrectomy. We present a clinical and morphological observation of a multicystic lesion in a 76-year-old patient's right kidney filled with keratinized masses and imitating a malignant solid tumor. The detailed gross, histological and immunohistochemical (desmin, cytokeratin 7, uroplakin and p63) analyses of the kidney tissue excluded the malignant nature of the lesion. The final differential diagnosis was between an epidermal cyst and calyceal diverticulum with pronounced squamous cell metaplasia of urothelium. The upper pole localization of the lesion, its connection with the pelvicalyceal system through the unobstructed isthmus, the presence of urothelial lining and smooth muscle cells in its wall let us diagnose a calyceal diverticulum type I. Knowledge of the key clinical and morphological features of epidermal cysts and diverticula of the pelvicalyceal system will help the practicing physicians suspect the benign nature of such lesions and perform organ-preserving operations.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case Report of Calyceal Diverticulum: Differential Diagnosis for Organ-Preserving Operations

et al. 2021

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“…Carcinoma in a calyceal diverticulum is extremely rare, with only 16 cases reported in the literature, to our knowledge. Moreover, only one case of primary squamous cell carcinoma in a calyceal diverticulum has previously been reported [ 1 – 7 ]. Among these 17 cases, including ours, the pathological findings included an urothelial carcinoma in 13 cases, urothelial carcinoma with squamous metaplasia in 2 cases, and squamous cell carcinoma in 2 cases [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Squamous Cell Carcinoma in a Calyceal Diverticulum Detected by Percutaneous Nephroscopic Biopsy

Mitome

Tabei

Tsuura

et al. 2018

Case Reports in Oncological Medicine

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A 73-year-old woman was referred to our department with a complaint of asymptomatic gross hematuria. Dynamic computed tomography revealed a complicated (Bosniak type IIF) cyst in the upper pole of her right kidney, which was diagnosed as a calyceal diverticulum. The diagnosis was confirmed by ureteroscopy. The diverticulum was filled with a soft protein matrix that was difficult to completely remove from the inner surface of the calyceal diverticulum. Endoscopy combined with intrarenal surgery (ECIRS) was performed to completely remove the matrix. Percutaneous nephroscopy further revealed papillary lesions on the surface of the diverticulum, confirmed as squamous cell carcinoma on pathological assessment. A laparoscopic right radical nephroureterectomy was performed, with curative intent. Pathological assessment confirmed a high-grade squamous cell carcinoma with renal parenchymal invasion (pT3). Although carcinomas in a calyceal diverticulum are highly uncommon, when present, these tend to be high-grade neoplasms that deeply invade the parenchymal wall. As the effective management of these lesions is difficult, early-stage diagnosis is required for curative treatment. We report the case of squamous cell carcinoma in a calyceal diverticulum that was difficult to diagnose on preoperative computed tomography, urinal cytology examination, and ureteroscopy but was found during ECIRS.

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“…Urothelial carcinoma developing in the pyelocalyceal diverticulum, as in the present case, is a very rare disease, with only 11 cases reported in Japan (Table 1 ). 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 Of these 11 cases, four were diagnosed as cystic renal cell carcinoma on preoperative examination, and these cases were difficult to distinguish from those of cystic kidney cancer on preoperative examination, as in the present case.…”

Section: Discussionmentioning

confidence: 59%

“…1 , 2 Furthermore, urothelial carcinoma developing in a pyelocalyceal diverticulum is extremely rare, and only 11 cases have been reported in Japan. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 Here, we report a rare case of urothelial carcinoma originating from a pyelocalyceal diverticulum, which was difficult to distinguish from cystic renal cell carcinoma.…”

Section: Introductionmentioning

confidence: 90%

A case of pyelocalyceal diverticulum urothelial carcinoma that was difficult to distinguish from cystic renal cell carcinoma preoperatively

et al. 2021

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Introduction Pyelocalyceal diverticulum is a rare disease sometimes difficult to distinguish from cysts. We report a case of urothelial carcinoma originating from a pyelocalyceal diverticulum, difficult to distinguish from cystic renal cell carcinoma preoperatively. Case presentation A 51‐year‐old Japanese man complained of gross hematuria. Computed tomography revealed a solid mass in one of the many cystic lesions in the left kidney. He was diagnosed with left cystic renal cell carcinoma and underwent retroperitoneal laparoscopic nephrectomy. Pathological examination revealed high‐grade invasive urothelial carcinoma arising within the renal pyelocalyceal diverticulum. The definitive diagnosis was high‐grade invasive urothelial carcinoma (pT3). In retrospect, the retrograde pyelography findings indicated the cyst and urinary tract connection. Residual ureterectomy and adjuvant chemotherapy were later performed. The patient has since been recurrence‐free. Conclusion Whether cystic renal cell carcinoma is suspected on imaging, pyelocalyceal diverticulum should be considered a differential diagnosis, though unlikely to be encountered in daily practice.

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Urothelial carcinoma in a pyelocaliceal diverticulum discovered by magnetic resonance urography

Cited by 3 publications

References 2 publications

A Case Report of Calyceal Diverticulum: Differential Diagnosis for Organ-Preserving Operations

A Case Report of Calyceal Diverticulum: Differential Diagnosis for Organ-Preserving Operations

Squamous Cell Carcinoma in a Calyceal Diverticulum Detected by Percutaneous Nephroscopic Biopsy

A case of pyelocalyceal diverticulum urothelial carcinoma that was difficult to distinguish from cystic renal cell carcinoma preoperatively

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