Renal squamous cell carcinoma: CT findings and clinical significance

Lee, T.-Y.; Ko, Sheung‐Fat; Wan, Yung‐Liang; Cheng, Y.-F.; Yang, Bing; Huang, Dan; Hsieh, Hsiao-Yun; Yu, Takayama; Chen, W.-J.

doi:10.1007/s002619900324

Cited by 56 publications

(65 citation statements)

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“…Significantly, due to nonspecific and insidious presenting symptoms, lack of specific radiological features, and rarity of this tumour, most cases of RSCC are undiagnosed preoperatively and diagnosis is only made by histopathological examination of the operated nephrectomy specimen. 3,4 Insidious onset of the disease, lack of any pathognomic sign or symptom and nonspecific findings on imaging leads to delay in diagnosis. Hence, most of the patients present with advanced disease, accounting for poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…2 Squamous cell carcinoma of the urinary tract is more frequently reported in urinary bladder and male urethra and rarely encounterd in renal pelvis. [3][4][5][6] The involvement is unilateral, equally common on the right and left sides. Tumour may present as loin pain, hematuria, abdominal lump or with anorexia and weight loss in advanced cases.…”

Section: Discussionmentioning

confidence: 99%

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A rare case report of primary renal squamous cell carcinoma

et al. 2017

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Primary renal squamous cell carcinoma is a very rare entity. Only few cases are reported in the world literature. Most of the patients present at a late stage resulting in poor prognosis. We report a 44 year old female who presented with a history of lump in right flank accompanied with a dull intermittent pain for 2 months duration which intensified in the last 15 days. Antecedent risk factors like renal calculi, analgesic use were absent. Computed Tomography (CT) examination revealed a mass arising from the superior pole of kidney with extension to the posterior segment of liver. Histopathology following nephrectomy showed histological features of well differentiated squamous cell carcinoma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A rare case report of primary renal squamous cell carcinoma

et al. 2017

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“…This rare malignancy is frequently associated with chronic pyelonephritis and renal stone formation. Other etiologic factors such as tuberculosis, immunosuppression with azathioprine, analgesic abuse with phenacetin, radiation therapy, chronic rejection in a transplant kidney and prior percutaneous nephrolithotomy have been associated with squamous cell carcinoma [4][5][6][7]. It is believed that chronic irritation leads to squamous metaplasia which may subsequently develop into squamous cell carcinoma [8].…”

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confidence: 96%

Squamous cell carcinoma must be considered in patients with long standing upper ureteral stone and pyonephrosis

et al. 2011

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A 69-year-old male patient with chronic alcoholism presented with a history of swelling and pain of right upper abdomen for the recent 6 months. He complained of generalized weakness and weight loss in the past 3 months. There was no history of fever and hematuria but he had occasional right flank pain. Physical examination revealed moderate right costovertebral angle tenderness and right palpable abdominal mass. Routine hematology, biochemical tests and chest radiograph were normal. Urinalysis revealed microscopic hematuria and pyuria. Urine cytology was negative for malignancy. Ultrasonography of the abdomen showed severe hydronephrosis of the right kidney with hydronephrotic sac suggestive of pyonephrosis and dilatation of the right ureter. The left kidney was normal in size, shape and echogenicity. Computed tomography (CT) of abdomino-pelvis showed severe hydronephrosis filling the right abdominal cavity, thin parenchyma of the right kidney suggestive of non-functioning kidney, several calyceal stones (\10 mm) and one stone (22 mm) in the upper ureter. There was no ascites or lymphadenopathy (Fig. 1).The patient was scheduled for a right nephrectomy through a flank incision. On operation, a huge kidney measuring 27 9 20 9 15 cm was obtained. The whole kidney with pyonephrosis was a distended sac-like structure without any visible renal tissue. The cut surface showed multiple areas with necrotic tissue and multiple calculi (Fig. 2).The final pathology report showed invasive, poorly differentiated squamous cell carcinoma (5 9 2, 5 9 2 cm), several renal stones and a stone in the right upper ureter. The tumor extended to perinephric fat and all surgical margins were negative. There was no regional lymphatic invasion of the tumor and no distant metastasis (pathological stage T3N0M0) (Fig. 3). The patient had an uneventful postoperative course and was discharged on postoperative day 7 in stable condition.At 5-months follow-up visit after the surgery, he presented with pain of right shoulder and generalized weakness. Follow-up CT scan showed multiple metastases in the liver and spleen and metastatic lymphadenopathy in the aortocaval and retrocaval spaces. This pathology was not visible on the previous CT scan (Fig. 4). The patient received one course of chemotherapy but he expired 7 months after surgery.Primary malignant tumors of the renal pelvis are relatively rare and constitute approximately 8-14% of all the renal malignancies [1]. Of these, squamous cell carcinoma of the renal collecting system is rare, accounting for about 0.5-8% of the renal pelvic tumors [2,3]. This rare malignancy is frequently associated with chronic pyelonephritis and renal stone formation. Other etiologic factors such as tuberculosis, immunosuppression with azathioprine, analgesic abuse with phenacetin, radiation therapy, chronic rejection in a transplant kidney and prior percutaneous nephrolithotomy have been associated with squamous cell carcinoma [4][5][6][7]. It is believed that chronic irritation leads to squamous metaplasia which ...

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“…[10,11] Nativ et al in their study divided renal SCC in three groups, reported 1 and 2 year survival rates of locally invasive renal SCC 33% and 22% respectively. [11] Metastatic disease survey is more shorter with reported median survival of 5 months.…”

Section: Dıscussıonmentioning

confidence: 99%

Primary renal squamous cell carcinoma: a case report

CETINDAG¹

2015

TJ Oncol

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Böbreğin skuamöz hücreli karsinom patolojik tanısı literatür-de nadiren yer alır. Hastalık agresif tabiatlı, beş yıllık yaşam %10'dan az ve prognoz kötüdür. Yetmiş dört yaşında erkek hasta karın ağrısı ve kilo kaybı şikayetleri ile başvurdu. Sağ nefrektomi yapıldı. Patoloji raporu orta derece diferansiye skuamöz hücreli böbrek karsinomu varlığını gösterdi. Pozitron emisyon tomografi görüntülerinde kalıntı hastalık ve metastatik lenfadenopatiler izlendi. Adjuvan kemoterapi ve radyoterapi uygulandı ancak hastalık ilerledi ve patolojik tanıdan altı ay sonra hasta kaybedildi. Primer skuamöz hüc-reli karsinom agresif bir tümördür ve böbrek taşı ile güçlü bir ilişkisi vardır. Tümörün erken tespiti için böbrek taşı ve nonfonksiyone böbreği olan hastalar, yeni görüntüleme teknikleri ile incelenmeli ve daha iyi sonuçlar için cerrahi sonrası adjuvan kemoterapi-radyoterapi kombinasyonları ile agresif tedaviler uygulanmalıdır.Anahtar sözcükler: Kemoterapi; yoğunluk ayarlı radyoterapi; radyoterapi; böbrek skuamöz hücreli karsinomu.Pathologic diagnosis of squamous cell carcinoma (SCC) of the kidney is rarely reported in the literature. The disease is aggressive in nature and the prognosis is dismal with a 5-year survival rate of less than %10. A 74-year-old man admitted with abdominal pain and weight loss. Right nephrectomy was performed. Pathology report delineated moderately differentiated SCC of the kidney. Positron emission tomography demonstrated residual mass and metastatic lymph nodes. Adjuvant treatments with chemotherapy and radiotherapy were applied but the disease was progressed and the patient was dead six months after pathologic diagnosis. Primary SCC is an aggressive tumor and these tumors are strongly associated with renal stones, the patients with renal stones and non-functioning kidney should be carefully examined with newer imaging modalities for early detection of the tumor, and warrants aggressive treatment with surgery followed by adjuvant aggressive combination chemotherapy-radiotherapy that may provide a better outcome.

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Renal squamous cell carcinoma: CT findings and clinical significance

Abstract: The central and peripheral types of RSCC were different biologically. High index of suspicion should be maintained when identifying the subtle clues of malignancy in patients with urolithiasis.

Cited by 56 publications

References 12 publications

A rare case report of primary renal squamous cell carcinoma

A rare case report of primary renal squamous cell carcinoma

Squamous cell carcinoma must be considered in patients with long standing upper ureteral stone and pyonephrosis

Primary renal squamous cell carcinoma: a case report

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