An Aggressive Urothelial Carcinoma in a Horseshoe Kidney- A Case Report

Abstract

Evidence of horseshoe kidney in Indian population is 1 in 600-800 individuals. Horseshoe kidney is predisposed to complications by virtue of its ectopic position, malrotation and associated vascular and ureteral anomalies. Incidence of Renal Cell Carcinoma (RCC) in a horseshoe kidney is same as that in general population. Other pelvic tumours, transitional tumours, Wilms tumour and carcinoids show a greater frequency. High grade urothelial carcinomas are quite rare with a few case reports available. An index case of 75 yeal old male presented with renal mass in an incidentally diagnosed horseshoe kidney on radiologic imaging. The case has been highlighted due to its poorly differentiated tumour morphology and aggressive nature. Further, immunohistochemistry was done to arrive at a correct diagnosis for appropriate treatment. The tumour cells showed positivity for Cytokeratin 7 (CK 7) and CK 5/6. They were negative for p63, PAX-8 (Paired-box gene 8). Also, it is technically difficult to excise large-sized renal mass in an anomalous kidney.

Interesting malignant renal tumours: a tripod of cases

“…Balawender et al reported that renal cell carcinoma was the most commonly detected tumour, followed by Wilms tumour and transitional cell carcinoma. 7 TCRCC has often been confused with other cystic lesions of the kidney like cystic nephroma (CN), mixed epithelial and stromal tumour (MEST) and multilocular cystic renal neoplasm of low malignant potential (MCNLMP). CN and MEST have a female predominance.…”

Upper Urinary Tract Urothelial Carcinoma With Squamous, Glandular, and Sarcomatoid Variants in a Horseshoe Kidney: A Novel Case Report and Literature Review

“…It involves the two kidneys being fused at their lower poles by the isthmus, a region consisting of fibrous tissue and parenchyma [ 6 ]. According to the current literature, renal cell carcinoma (RCC) is considered the most common type of tumor in the horseshoe kidney, with an incidence no higher than the normal population [ 5 ]. However, renal pelvis UC is more frequent in cases with horseshoe kidneys than in the normal population possibly due to the increased risk of chronic obstruction, increased prevalence of renal calculi, and recurrent urinary infection [ 6 ].…”

“…Currently, there are 200 reported cases of tumors in the horseshoe kidney. Balawender K et al reported that the most common tumor detected is RCC, which constitutes 45% of the tumors, followed by Wilms and TCC, accounting for 20% of tumors in the horseshoe kidney [ 5 ].…”

“…Patients with upper urinary tract UC vary in terms of recurrence and survival rate, depending mainly on the grade and pathological stage of the tumor [ 4 ]. Horseshoe kidney is considered one of the most common congenital anomalies in the kidneys, with an incidence of approximately one in 600-800 individuals [ 5 ]. Renal pelvic UC occurs more frequently in cases with horseshoe kidneys than in the normal population [ 6 ].…”