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

Abstract

Horseshoe kidney is a congenital anomaly, which consists of fusion of the lower poles of the kidneys. Cancer in a horseshoe kidney is common, possibly because of the increased risk of chronic obstruction, renal calculi, and recurrent urinary infection. We report a case of a 64-year-old male with a horseshoe kidney who presented to our hospital with gross hematuria and flank pain, which was highly suggestive of pyelonephritis. Comprehensive workup and imaging were performed and showed an extremely rare form of tumor consisting of three histological variants: squamous, glandular, and sarcomatoid. To the best of our knowledge, this is the first case reported with these three histological variants in a horseshoe kidney.

Complete Response of Rare Sarcomatoid Upper Tract Urothelial Carcinoma Variant: Case Report and Literature Review

“…In general, it is difficult to establish a histopathological diagnosis of preoperative infiltrating urothelial sarcomatoid carcinoma variant, due to the lack of characteristics of this malignancy. Most diagnoses are made based on postoperative histological and immunohistochemical pattern findings [5].…”

“…However, the clinical presentation of upper urothelial carcinoma is often nonspecific. Patients often get detected at later stages of the pathology, which often results in an overall poor prognosis [5]. This report aims to present a rare case and to share the diagnostic and treatment approach for a better understanding of upper urinary tract infiltrating urothelial cell carcinoma with the sarcomatoid histological variant.…”

Laparoscopic Nephroureterectomy with Heminephrectomy for Urothelial Carcinoma of the Upper Renal Pelvis on the Left Side of the Horseshoe Kidney

“…Horseshoe kidney is a congenital abnormality in which the two kidneys are fused at their lower poles by a region of parenchymal and fibrous tissue called the isthmus [2]. There is no known association of horseshoe kidney with urothelial cancer; however, there are several case reports describing surgical management of tumors in patients with horseshoe kidney [3][4][5][6][7]. Herein, we present a case of urothelial carcinoma in the left renal pelvis of the horseshoe kidney.…”