Small Cell Carcinoma of the Renal Pelvis: A Case Report and Review of the Literature

Abstract

Extrapulmonary small cell carcinoma occurs in nearly all organs except the central nervous system and the liver. We are presenting a case of renal small cell carcinoma (SCC) with two unique characters. A 75-year-old patient was evaluated for back pain with no other complaints. Magnetic Resonance (MR) imaging of the abdomen revealed homogeneous tumor in the left renal pelvis extending beyond the kidney. Metastatic workup was negative. A left nephroureterectomy was performed. Histopathology and immunohistochemistry revealed a small cell carcinoma of the renal pelvis. The patient declined adjuvant therapy and died 2 months after surgery due to unrelated causes. After comprehensive worldwide literature search, we found 13 cases of SCC of the renal pelvis, including the current case. The mean age was 61.6 years (37–83), with a M : F ratio of 1 : 1.8. The average duration of symptoms was 71.4 days (21–168). Gross hematuria was the most common symptom (69.2%) followed by pain (61.5%). Adjuvant chemotherapy was provided to 4 patients (30.7%), and neoadjuvant to 1 patient. The median survival of patients who did and did not receive chemotherapy was 5.5 months (3–8) and 6 months (2–31), respectively, P < .50. In conclusion, renal SCC (both parenchymal and pelvic SCC) is a rapidly fatal disease with a median survival of ≤8 months.

Genitourinary Small-Cell Carcinoma: A Single-Institution Experience

“…Extrapulmonary scc has been described in various organs, including these genitourinary (gu) tract sites [2][3][4][5][6][7][8][9] : the urinary bladder (ub), which is the most common site for gu scc; the prostate; and the upper urinary tract (uut), including the ureters and kidneys 5,6,9 .…”

“…Available knowledge is based mainly on small retrospective series and case reports [2][3][4][5][6][7][8][9] . Because no randomized trials have studied patients with gu scc, there is no standard approach for managing the malignancy.…”

Management of small cell carcinoma of the bladder: Consensus guidelines from the Canadian Association of Genitourinary Medical Oncologists (CAGMO)

“…2,3 Extra-pulmonary SCC was first described by Duguid and Kennedy in 1930 4 and subsequently has been reported in the gastrointestinal tract, 5 head and neck 6 and genitourinary (GU) system. 7 SCC of the GU system (SCCGU) are uncommon, but can occur in the kidneys, 8 renal pelvis, 9 ureter, 10 bladder, 7 urachus, 11 urethra 12 and prostate. 13 Although rare, these cancers are not insignificant.…”