A renal cell carcinoma extending into the renal pelvis simulating transitional cell carcinoma

Abstract

A case of renal cell carcinoma with unusual extension is reported, in which the radiographic findings have a close resemblance to those of transitional cell carcinoma of the renal pelvis. We emphasize that it is occasionally difficult to draw a distinction between transitional cell carcinoma with renal invasion and renal cell carcinoma with renal pelvic extension even by computed tomography (CT) and angiography.

Renal Cell Carcinoma with Intraluminal Spread of the Entire Upper Urinary Tract

“…Munechika et al [3], Chen et al [4], and Fujita et al [5] reported similar cases, although the tumor extension was limited in the renal pelvis and ureter. Gulati et al [6] reported a case in which the tumor protruding from the ureteral orifice was resected transurethrally and confirmed as a clear cell RCC.…”

Coexpression of cytokeratins 7 and 20 confirms urothelial carcinoma presenting as an intrarenal tumor

“…1,2 Unfortunately, overlapping imaging patterns are not uncommon, such as when urothelial carcinoma presents as a predominantly parenchymal mass 3 or renal cell carcinoma extends into the renal pelvis. 4 The usefulness of CK7 and CK20 in determining the primary site of a carcinoma has been documented for several clinical settings, including lung versus colon, uterus versus colon, and metastatic carcinoma presenting in the liver. [5][6][7][8][9][10][11] The unique CK profiles of carcinomas from various primary sites make these powerful tools, and our results show that CK7 and CK20 coexpression is a useful test to confirm urothelial origin and to rule out renal cell carcinoma in patients with renal masses.…”

“…[1][2][3][4] Because the management of urothelial carcinoma versus renal cell carcinoma is different, the ability to differentiate these tumors is important in surgical planning and subsequent clinical decision making. Cytokeratins (CK) 7 and 20 have been shown to have unique and distinct patterns of expression in benign and malignant epithelia from various organ sites.…”

Renal cell carcinoma growing into the renal pelvis and mimicking transitional cell carcinoma: A case report and literature review

“…Histological analysis revealed a clear-cell RCC with renal pelvic invasion, which is a rare carcinoma reported only in a small number of cases in the English literature (Table I) (3–9). Due to inadequate preoperative diagnosis of TCC, nephroureterectomy has been performed in a number of previous cases (3,5). However, nephroureterectomy including cuff resection of the bladder wall was performed in one case since frozen section analysis was unable to exclude TCC (8).…”

“…Although the majority of malignancies originating in the renal pelvis are TCC, RCC has a tendency to grow into the renal pelvis. The imaging findings of RCC and TCC in the renal pelvis are nonspecific; therefore, preoperative differentiation between RCC and TCC is important in order to identify the type of surgical treatment required: Nephrectomy or ureteronephrectomy (3–5). The present study presents a rare case of an RCC growing into the renal pelvis, in which TCC of the renal pelvis was not able to be distinguished using contrast enhanced computed tomography (CT) or CT urography (CTU).…”