Association of Kidney Stones with Upper Tract Urothelial Carcinoma Revealed Incidentally by an Attempt at Percutaneous Nephrolithotomy: About A Case

Abstract

The applicability of the recommendations of the European Association of Urology (EAU) concerning the diagnostic evaluation of upper urinary tract urothelial carcinoma (UTUC) can sometimes come up against complex clinical features such as the association of upper urinary tract (UUT) stones with UTUC where it is masked by stones thus making its diagnosis difficult. Hence its incidental discovery during the treatment of the stones, thus reflecting a non-recommended diagnostic approach to UTUC. We report a case of UTUC revealed incidentally by an attempt at right percutaneous nephrolithotomy (PCNL) for kidney stones in a 72-year-old Moroccan with history of chronic smoking, extra corporal shock wave lithotripsy (ESWL) for right kidney stone, who consulted at the Military Hospital in Rabat for chronic right low back pain associated with intermittent macroscopic hematuria. In whom the reference diagnostic assessment of UTUC and retrograde pyelography (RP) could not establish the diagnosis. The interest of this case is to insist on the possibility of a coexistence of stones with UTUC in the event of macroscopic hematuria associated with UUT stones. In addition, this case makes it possible to report the limitations of the accuracy of the reference diagnostic assessment of UTUC.