Renal pyelocalyceal squamous cell carcinoma in a patient with an ectopic kidney presenting with chronic pyelonephritis: a case report

Abstract

Background Until now, few cases of pelvis squamous cell carcinoma in various renal anomalies have been reported. To our knowledge, primary squamous cell carcinoma arising from a pelvic ectopic kidney has never been described. In this report, we describe a case of renal pyelocalyceal squamous cell carcinoma in a patient with an ectopic kidney presenting with chronic pyelonephritis. Case summary A 73-year-old Caucasian woman presented to our hospital with pyelonephritis symptoms. Abdominopelvic computed tomography revealed heterogeneous and irregular minimal contrast enhancement in the pelvic ectopic kidney parenchyma. Radiologists reported that the images were consistent with chronic pyelonephritis. A Tc-99m dimercaptosuccinic acid renal scan demonstrated a nonfunctioning right pelvic ectopic kidney. The patient underwent open simple nephrectomy via modified Gibson incision. The whole mass was a distended, saclike structure without any grossly visible renal tissue. Pathological examination showed renal pelvis squamous cell carcinoma 8 cm in diameter infiltrating into the renal capsule and perinephritic fatty tissue. The patient was staged as T4N0M1 renal pelvis squamous cell carcinoma. The patient was being treated in the intensive care unit for respiratory distress on the seventh day after the operation. By the first-month follow-up visit, the patient had died of acute respiratory distress syndrome. Conclusions Although rare, renal pelvis squamous cell carcinoma should be considered in the differential diagnosis of a renal mass in patients who have renal anomalies and chronic pyelonephritis.

A case report of complete pathological remission after chemotherapy in a patient with primary renal squamous cell carcinoma

“…Renal squamous cell carcinoma is rare and is associated with chronic inflammation due to renal stones or chronic infection. There have been only 2 previous reports of 3 cases of xanthogranulomatous pyelonephritis with renal squamous cell carcinoma (14,18). In this report, the patient presented similar clinical manifestations as those in previous reports (14,18,36), including initial symptoms of urinary infection (fever, low back pain), elevated peripheral blood white blood cell and neutrophil counts with moderate anemia, elevated CRP, and urine white blood cells and occult blood.…”

“…There have been only 2 previous reports of 3 cases of xanthogranulomatous pyelonephritis with renal squamous cell carcinoma (14,18). In this report, the patient presented similar clinical manifestations as those in previous reports (14,18,36), including initial symptoms of urinary infection (fever, low back pain), elevated peripheral blood white blood cell and neutrophil counts with moderate anemia, elevated CRP, and urine white blood cells and occult blood. After surgery, the clinical symptoms disappeared, and blood test results, urine analysis results, and CRP level returned to normal.…”

“…SCC of urothelial tract is thought to arise through a process of squamous metaplasia of urothelium (7). It may be triggered by chronic irritation and infection such as polycystic kidney disease (7), prolonged use of immunosuppressants (8,9), chronic inflammation (10)(11)(12)(13)(14)(15)(16)(17)(18), kidney stones (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), and horseshoe kidney (25,(30)(31)(32)(33)(34). Early symptoms are atypical including recurrent urinary infections, ongoing pyuria, hematuria or backache.…”

Incidental squamous cell carcinoma of renal pelvis presenting as skin invasion: a case report

“…In the early stage, the clinical manifestation of renal SCC is nonspecific. It has been reported that most cases of SCC of the renal pelvis present with hydronephrosis, chronic pyelonephritis, kidney stones, and renal cysts [2,[6][7][8]. SCC cases also have been discovered in the kidneys with various anomalies such as horseshoe kidney, ectopic kidney, polycystic kidney disease, and renal calyceal diverticulum [2].…”