Xanthogranulomatous Pyelonephritis Associated with Transitional Cell Carcinoma of the Renal Pelvis

Val‐Bernal, J. Fernando; Castro, Ferrari de

doi:10.1159/000282924

Cited by 16 publications

(9 citation statements)

References 11 publications

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“…Leong et al [4] , in a series of 17 patients with TCC of the renal pelvis, noted ipsilateral stones in 6 cases, and Kinn [1] reported on 4 patients with stone disease out of 27 with TCC of the renal pelvis. TCC of the kidney has been sporadically reported in patients suffering from xanthogranulomatous pyelonephritis and staghorn stones [8][9][10] .…”

Section: Discussionmentioning

confidence: 99%

Urothelial Cancer of the Renal Pelvis in Percutaneous Nephrolithotomy Patients

Katz¹,

Gofrit²,

Golijanin³

et al. 2005

Urol Int

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Introduction: The association between staghorn calculus of the kidney long-standing and urothelial tumors of the renal pelvis is well documented. We describe 3 patients with urothelial cancer in a kidney who underwent percutaneous nephrolithotomy (PCNL). Patients and Methods: Retrospective analysis of our series of more than 500 PCNLs revealed 3 patients in whom urothelial cancer of the renal pelvis was diagnosed during or following percutaneous stone removal. Preoperative assessment included IVP, renal sonography and renal scan using DTPA in all 3 patients, and CT in 2 patients. Imaging did not raise the suspicion of a neoplastic lesion. Results: All patients had a long history of urolithiasis and urinary infections. No patient was diagnosed preoperatively. One patient was diagnosed postoperatively, when a CT demonstrated a renal lesion. The second patient underwent simple nephrectomy due to a non-functioning kidney, and the tumor was found on pathological analysis. In the third patient, biopsies were taken from a suspicious-looking tissue in the renal pelvis during the PCNL session. All patients had transitional cell carcinoma: 1 associated with sarcomatoid features and 1 with squamous carcinoma. They all died from metastatic disease 2–19 months after the diagnosis of urothelial cancer. Conclusions: The preoperative diagnosis of urothelial cancer in patients with staghorn stones is difficult due to the existing stone and inflammation. Since the prognosis of urothelial cancer is extremely poor, biopsies of the renal pelvis, obtained directly through the nephroscope during the PCNL session, may be the only key for early diagnosis and treatment. A high index of suspicion should be raised when patients suffering from infected staghorn calculi are encountered, and such intraoperative biopsies should be considered.

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Section: Discussionmentioning

confidence: 99%

Urothelial Cancer of the Renal Pelvis in Percutaneous Nephrolithotomy Patients

Katz¹,

Gofrit²,

Golijanin³

et al. 2005

Urol Int

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“…A large-or a staghorn calculus is found in up to 80 % of cases. Association with TCC of the renal pelvis, as presented in the first case, is very rare, occurring in only 3.3 % of cases [3]. Xanthogranulomatous pyelonephritis has been described in patients with ileal loop diversion with tumour recurrence [4]; however, no underlying obstruction was found in our second case.…”

Section: Discussionmentioning

confidence: 50%

Xanthogranulomatous pyelonephritis: MRI findings in the diffuse and the focal type

et al. 2000

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“…However, as far as we are aware, there has not been any mention of XGPN and TCC presenting as acute pyelonephritis and perinephric abscess. Obstruction, long-term inflammation, and mechanical irritation by stones have been postulated as culprits in the pathogenesis of TCC in the presence of XGPN [5]. Eighty percent of reported XGPN have an associated staghorn calculus, but not in this case.…”

Section: Discussionmentioning

confidence: 65%

“…There are only few reports of concomitant XGPN and TCC affecting the kidney [5], [6], [7]. However, as far as we are aware, there has not been any mention of XGPN and TCC presenting as acute pyelonephritis and perinephric abscess.…”

Section: Discussionmentioning

confidence: 95%

High-grade transitional cell carcinoma masquerading as a xanthogranulomatous pyelonephritis and perinephric abscess

Ordones

Das

Prowse

et al. 2017

Radiology Case Reports

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Xanthogranulomatous pyelonephritis (XGPN) is an atypical long-term pyelonephritis with destruction of renal parenchyma and a long-term inflammatory infiltrate of macrophages. Reported presentations of transitional cell carcinoma (TCC) are different. A 73-year-old woman presented with loin pain, prostration, and fever. Computed tomography scan revealed poor cortical enhancement of the kidney, but some of the images bore resemblance to the characteristic “bear's paw” sign, consistent with XGPN with a 7-cm perinephric collection. She was provisionally diagnosed as severe acute pyelonephritis, possibly XGPN, with abscess. In view of the poor clinical condition, decision was made to perform nephrectomy. Histology revealed a G3pT4 high grade TCC with perineural and vascular invasion and reactive xanthogranulomatous inflammatory response. There are few reports of concomitant XGPN and TCC affecting the kidney. However, there has not been any mention of XGPN and TCC presenting as acute pyelonephritis and perinephric abscess so far.

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Xanthogranulomatous Pyelonephritis Associated with Transitional Cell Carcinoma of the Renal Pelvis

Cited by 16 publications

References 11 publications

Urothelial Cancer of the Renal Pelvis in Percutaneous Nephrolithotomy Patients

Urothelial Cancer of the Renal Pelvis in Percutaneous Nephrolithotomy Patients

Xanthogranulomatous pyelonephritis: MRI findings in the diffuse and the focal type

High-grade transitional cell carcinoma masquerading as a xanthogranulomatous pyelonephritis and perinephric abscess

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