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

Kakutani, Shigenori; Kume, Haruki; Hirano, Yuki; Wakita, Toshihiko; Homma, Yukio

doi:10.1155/2013/371387

Cited by 5 publications

(8 citation statements)

References 7 publications

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“…Invasion is easier in the renal pelvis compared with the renal parenchyma when localized RCC originates in the marginal parenchyma surrounding the renal pelvis or when RCC invades the entire kidney. In the present case, RCC did not invade the normal urothelium of the renal pelvis; however, in a number of previous cases, the tumors had expanded into the ureter and bladder ( 7 , 9 ). Therefore, the present study provides fundamental evidence for the following theory: Implantation and/or invasion of the urothelial mucosa followed by intraluminal expansive growth results in the pathogenesis of RCC with pelvic extension ( 9 ).…”

Section: Discussioncontrasting

confidence: 60%

“…In the present case, RCC did not invade the normal urothelium of the renal pelvis; however, in a number of previous cases, the tumors had expanded into the ureter and bladder ( 7 , 9 ). Therefore, the present study provides fundamental evidence for the following theory: Implantation and/or invasion of the urothelial mucosa followed by intraluminal expansive growth results in the pathogenesis of RCC with pelvic extension ( 9 ). Previous cases reporting RCC growth along the urinary tract support the following mechanism of RCC metastasis: Tumor cells may metastasize via intraluminal transit down the urinary tract and invade the distal ureter or bladder ( 7 , 9 ).…”

Section: Discussioncontrasting

confidence: 60%

“…The present study reported the challenging diagnosis of a marginally-enhanced renal pelvic mass that was identified using dynamic CT/CTU. 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 ).…”

Section: Discussionmentioning

confidence: 99%

“…In cases of uncertain diagnosis, the present study advocates that appropriate ureteroscopy and biopsy should be performed to provide crucial histopathological information as the most important evidence. In certain cases, ureteroscopy cannot be performed due to urethral edema, stricture or obstruction; therefore, frozen section analysis is recommended to determine any required changes to the surgical strategy ( 4 , 5 , 9 ).…”

Section: Discussionmentioning

confidence: 99%

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

Ding

Chen

et al. 2015

Oncology Letters

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Renal cell carcinoma (RCC) originated from parenchyma and the majority of malignancies originating in the renal pelvis are transitional cell carcinoma (TCC). In the present study, a rare case of RCC growing into the renal pelvis and mimicking TCC in medical imaging is reported. The preoperative differentiation between RCC and TCC is important in order to identify the type of surgical treatment required: Nephrectomy or ureteronephrectomy. The role of ureteroscopy and biopsy is emphasized in the accurate preoperative diagnosis of a renal pelvic mass. Thus, the present study provided fundamental evidence for the pathogenesis of RCC with pelvic extension and challenged the present tumor node metastasis staging system of RCC.

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Section: Discussioncontrasting

confidence: 60%

Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Ding

Chen

et al. 2015

Oncology Letters

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“…Gulati and colleagues in 2007 and Katukani and coworkers in 2013 presented cases of RCC invading the collecting system with direct extension down the ureter and protruding from the ureteral orifice in the bladder. 1 , 2 In 2011, Fujita and colleagues reported a case of RCC with tumor thrombus formation in the renal pelvis and the whole ureter. 3 On histopathological analysis, all three cases were reported as ccRCC.…”

Section: Discussionmentioning

confidence: 99%

Clear Cell Renal Cell Carcinoma with a Ureteral Thrombus

John

Aldera

Sinha

et al. 2018

Journal of Endourology Case Reports

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Introduction: Cancers of the kidney, arising from either the renal parenchymal tissue or the renal pelvis, is among the 13 commonest types of malignancy globally, accounting for between 3% and 4% of all newly diagnosed cancers. Renal cell carcinoma (RCC) accounts for 85% of all malignant renal neoplasms. We present a rare case of an RCC directly extending into the renal pelvicalyceal system and with a thrombus within the ureter.Case Presentation: A 39-year-old woman presented with a long-standing history of worsening left flank pain, intermittent visible hematuria, and a fullness in the left flank. Apart from an ill-defined left flank mass with pain on palpation, there was nothing remarkable on clinical examination. Contrast-enhanced abdominal CT scan images showed a large, heterogeneously enhancing soft tissue mass arising from the lower pole of the left kidney. The collecting system and the left proximal ureter were poorly visualized. A tentative diagnosis of RCC, cT3aN0M0 was made. Intraoperatively, we identified a large, left lower pole renal mass, displacing the pedicle superiorly. In addition, we found a bulky, dilated proximal ureter. A decision was made intraoperatively to proceed with radical nephrectomy and ureterectomy.Conclusion: We report a rare case of RCC directly invading from the renal pelvis and down the ureter as a thrombus mass, with no microscopic individual tumor implants in the ureter wall, invasion of the renal vein, or invasion of adjacent organs. To our knowledge, only four such cases have been reported in English literature, and as a result, very few theories explaining renal pelvic invasion and direct growth down the ureter have been postulated. This highlights the significance of adding invasion of the pelvicalyceal system as part of the most recent, updated tumor node metastases classification. In future, consideration needs to be given to include the extension of RCC into the ureter and/or bladder.

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