Presentation of mucinous adenocarcinoma of
                                                  renal pelvis masquerading as gross hydronephrosis:
                                                  A histopathological surprise

Patel, Kajal; Patel, Nitin A; Gandhi, Sailaxmi

doi:10.4103/2278-330x.208838

Cited by 5 publications

(4 citation statements)

References 5 publications

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“…However, there are two leading theories widely accepted by most researchers. One theory holds that mucosal epithelium of renal pelvic may undergo glandular metaplasia under long-term chronic irritations such as nephrolithiasis, hydronephrosis and infection, and then abnormal hyperplasia and adenocarcinoma possibly occur ( 10 , 11 ). Because of the increased incidence of the lesions in anomalous kidneys such as horseshoe kidney and non-functioning kidney, the other theory suggests that primary mucinous adenocarcinoma also may arise from the sequestered renal epithelium within the parenchyma as a consequence of maldevelopment ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

Primary mucinous adenocarcinoma of the left renal pelvis with ectopic inferior vena cava and invasion of the left renal vein and the adjacent inferior vena cava: a case report

Han¹,

Xie²,

Tang³

et al. 2021

Transl Cancer Res TCR

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Primary mucinous adenocarcinoma of renal pelvis is an extremely uncommon malignant tumor without typical clinical manifestations and imaging characteristics. A definite diagnosis often depends on postoperative pathological results. Operation is the preferred choice of treatment, but prognosis is unsatisfactory. We describe a 42-year-old male patient who was admitted for repeated and intermittent pain of left abdominal flank for more than 5 years and aggravation of the symptom for more than 1 month. In the course of disease, he was misdiagnosed twice as a renal cyst in other hospitals. However, mild percussive pain was discovered in the left kidney area during this hospitalization. Moreover, abdominal computed tomography (CT) scan of our hospital demonstrated that a huge mixed-density mass derived from left kidney, along with congenital variation of the inferior vena cava and filling defect area in the left renal vein and the adjacent inferior vena cava. After adequate preoperative preparation, he was treated with radical resection of the left kidney and artificial vascular replacement of the inferior vena cava segment containing the emboli. The mass was verified to be mucinous adenocarcinoma by postoperative pathological result. In the end, he was diagnosed as primary mucinous adenocarcinoma of the left renal pelvis with ectopic inferior vena cava and invasion of the left renal vein and the adjacent inferior vena cava. Two weeks after operation, he recovered and was discharged. There was no evidence of recurrence after more than 4 years of followup. Blood oncogenic biomarkers were valuable in diagnosis by reviewing literature. In conclusion, Primary mucinous adenocarcinoma of the kidney is easy to be misdiagnosed as renal cyst. Preoperative CT and blood oncogenic biomarkers are extremely important for preliminary diagnosis. Postoperative pathological result is the gold standard for final diagnosis. Although prognosis is generally unfavourable, radical resection of the tumor can benefit patients.

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Section: Discussionmentioning

confidence: 99%

Primary mucinous adenocarcinoma of the left renal pelvis with ectopic inferior vena cava and invasion of the left renal vein and the adjacent inferior vena cava: a case report

Han¹,

Xie²,

Tang³

et al. 2021

Transl Cancer Res TCR

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“…These were consistent with the classic triad of renal cancer, indicating long-standing or latestage disease. It is reported that the long-standing obstruction, chronic irritation, and infection can contribute to glandular metaplasia of the urothelium, dysplasia, and adenocarcinoma (8). However, some researchers thought that suspecting or diagnosing this tumor via history taking and physical examination were impossible (1).…”

Section: Discussionmentioning

confidence: 99%

Primary mucinous adenocarcinoma of the renal pelvis misdiagnosed as calculous pyonephrosis: a case report and literature review

Xie

Zhao

et al. 2020

Transl Androl Urol

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Primary mucinous adenocarcinoma of the renal pelvis is a rare malignant disease that is difficult to diagnose preoperatively. There are still no characteristic symptoms, radiological features, or standard treatment for this tumor with only ~100 cases reported. The prognosis is poor. We report a case of a 66-year-old man who presented with a 2-month history of fever and right waist pain. He was misdiagnosed with calculous pyonephrosis and underwent percutaneous nephrostomy (PCN) at a local hospital. Gelatinous material was drained via a PCN catheter. He was then transferred to our hospital. He had elevated CEA and CA19-9. We performed an open radical nephrectomy and found polypoid, gelatinous material and stones filling the renal pelvis. He was diagnosed with primary mucinous adenocarcinoma of the renal pelvis by pathology. He refused adjuvant chemotherapy and there was no sign of recurrence after one year of followup. By assessing a literature review of all of the cases reported since 2000, we recommend that careful history taking, serum tumor markers, and CT scans may improve the diagnostic accuracy rates and radical nephrectomy with total ureterectomy accompanied by adjuvant therapy may improve the prognosis.

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“…Surgery is the treatment of choice for mucinous adenocarcinoma of the renal pelvis, standard therapy being radical nephroureterectomy and bladder cuff excision [ 13 ], [ 14 ]. Due to the rarity of this tumor and lack of properly representative data, the role of adjuvant chemotherapy or radiotherapy is still not clear.…”

Section: Discussionmentioning

confidence: 99%

Mucinous adenocarcinoma of renal pelvis in a young male: a diagnostic challenge

Gupta

Agarwal²,

Sharma

et al. 2020

GMS German Medical Science; 18:Doc11

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Presentation of mucinous adenocarcinoma of renal pelvis masquerading as gross hydronephrosis: A histopathological surprise

Cited by 5 publications

References 5 publications

Primary mucinous adenocarcinoma of the left renal pelvis with ectopic inferior vena cava and invasion of the left renal vein and the adjacent inferior vena cava: a case report

Primary mucinous adenocarcinoma of the left renal pelvis with ectopic inferior vena cava and invasion of the left renal vein and the adjacent inferior vena cava: a case report

Primary mucinous adenocarcinoma of the renal pelvis misdiagnosed as calculous pyonephrosis: a case report and literature review

Mucinous adenocarcinoma of renal pelvis in a young male: a diagnostic challenge

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