The role of intraoperative kidney mucosal biopsy on screening of squamous cell carcinoma of the kidney in nephrolithiasis patients with stones larger than 20 mm

Abstract

<jats:sec><jats:title>Introduction:</jats:title><jats:p> Renal pelvic squamous cell carcinoma is a very rare tumor, with a prevalence &lt;1% of all urinary tract tumors, about 0.5–8% of all kidney tumors, and the average age is 50–70 years. Although the incidence of renal squamous cell carcinoma is less common than renal cell carcinoma and renal transitional cell carcinoma, due to its more aggressive nature renal squamous cell carcinoma is often found intraoperatively and is already in an advanced stage or metastasis. The relevant medical history of squamous cell carcinoma is pyelonephritis, chronic nephrolithiasis, and a history of kidney stone surgery. Data which was obtained from previous research at Hasan Sadikin Hospital, from January 2014–December 2017, found the incidence of renal squamous cell carcinoma from nephrectomy procedures was 6%. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> This study was a cross-sectional study with a correlative analytic study, samples were taken consecutively from biopsy of kidney mucosa intraoperatively in hospitalized patients with kidney stones with size larger than 20 mm at the Department of Urology, Hasan Sadikin Hospital Bandung, which performed open kidney surgery or percutaneous nephrolithotomy from January–May 2019. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The number of samples in this study were from 30 patients, consisting of 16 males and 14 females. Five patients underwent open kidney surgery and 25 patients underwent percutaneous nephrolithotomy surgery, with an average of age of 49.5±11.8 years and 63.3% of patients were aged from 40–60 years. In this study, one patient (3.3%) showed squamous cell carcinoma of the kidney, a 57-year-old male patient with a left staghorn kidney stone who underwent left percutaneous nephrolithotomy surgery. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> There is a benefit for intraoperative kidney mucosal biopsy as a screening for squamous cell carcinoma of the kidney in nephrolithiasis patients with stones larger than 20 mm. </jats:p></jats:sec><jats:sec><jats:title>Level of evidence:</jats:title><jats:p> 3 </jats:p></jats:sec>

Renal cell carcinoma in a patient with staghorn stones: A case report

“…Biopsy of the renal pelvis and calyx walls in cases of old/chronic stones and large stones, especially staghorn stones should be considered. This is due to the poor prognosis in progressive squamous cell carcinoma (SCC), so that early diagnosis and definitive treatment can be carried out [ 30 ]. Biopsy of the renal pelvis and calyx walls is suggested for patients who have old/chronic and large stones without any signs of malignancy on CT scan.…”