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Incidental Diagnosis of Renal Pelvic Tumor in Patients Who Underwent Percutaneous Nephrolithotomy: A Report of 6 Cases and Review of the Literature

  • Lizhe An
    Affiliations
    Urology and Lithotripsy Center, Peking University People's Hospital, Beijing, China

    Applied Lithotripsy Institute, Peking University, Beijing, China
    Search for articles by this author
  • Liulin Xiong
    Affiliations
    Urology and Lithotripsy Center, Peking University People's Hospital, Beijing, China

    Applied Lithotripsy Institute, Peking University, Beijing, China
    Search for articles by this author
  • Qingquan Xu
    Correspondence
    Address correspondence to: Qingquan Xu, M.D., Urology and Lithotripsy Center, Peking University People's Hospital, Applied Lithotripsy Institute, Peking University, 100034, Beijing, China
    Affiliations
    Urology and Lithotripsy Center, Peking University People's Hospital, Beijing, China

    Applied Lithotripsy Institute, Peking University, Beijing, China
    Search for articles by this author
  • Liang Chen
    Affiliations
    Urology and Lithotripsy Center, Peking University People's Hospital, Beijing, China

    Applied Lithotripsy Institute, Peking University, Beijing, China
    Search for articles by this author
  • Kai Ma
    Affiliations
    Urology and Lithotripsy Center, Peking University People's Hospital, Beijing, China

    Applied Lithotripsy Institute, Peking University, Beijing, China
    Search for articles by this author
  • Xiaobo Huang
    Affiliations
    Urology and Lithotripsy Center, Peking University People's Hospital, Beijing, China

    Applied Lithotripsy Institute, Peking University, Beijing, China
    Search for articles by this author
Published:September 23, 2022DOI:https://doi.org/10.1016/j.urology.2022.09.005

      Abstract

      Objectives

      To report the clinical characteristics of patients who were incidentally diagnosed as renal pelvic tumor during or after percutaneous nephrolithotomy (PNL).

      Methods

      The profiles of about 8,000 patients who underwent PNL in our center from 2011 to 2021 were retrospectively reviewed, 6 patients were diagnosed with renal pelvic tumor during or after PNL. Clinical data of these six patients were collected and summarized.

      Results

      Four males and two females with the average age of 59 years were researched. Chief complaints included loin pain, gross hematuria, and wound infection after PNL. Two patients had a definite long history of stones. Urinary tract infection occurred in 5 patients and all six patients had gross hematuria or microscopic hematuria. CT images revealed severe hydronephrosis in 4 patients and moderate hydronephrosis in 2 patients. Both staghorn and multiple stones were separately seen in 3 patients. Five patients were diagnosed with renal pelvic urothelial carcinoma via biopsy during PNL. One patient was diagnosed as renal pelvic tumor with extensive invasion by postoperative CT scan and received palliative treatment. Of two patients underwent radical surgery, one patient obtained long survival, one patient received endoscopic tumor resection and also obtained long survival. Two patients underwent renal artery embolization, one patient was still alive after 22 months, the other patient showed tumor growth in 3 weeks.

      Conclusions

      The possibility of renal pelvic tumor should be considered in stone patients with several risk factors including elder age, long history of stones, complicated stones, hydronephrosis especially pyonephrosis, obvious hematuria etc.
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      References

        • Turk C
        • Petrik A
        • Sarica K
        • et al.
        EAU guidelines on interventional treatment for urolithiasis.
        Eur Urol. 2016; 69: 475-482
        • Roupret M
        • Babjuk M
        • Comperat E
        • et al.
        European guidelines on upper tract urothelial carcinomas: 2013 update.
        Eur Urol. 2013; 63: 1059-1071
        • Chung SD
        • Liu SP
        • Lin HC.
        A population-based study on the association between urinary calculi and kidney cancer.
        Can Urol Assoc J. 2013; 7: E716-E721
        • Yeh CC
        • Lin TH
        • Wu HC
        • Chang CH
        • Chen CC
        • Chen WC.
        A high association of upper urinary tract transitional cell carcinoma with nonfunctioning kidney caused by stone disease in Taiwan.
        Urol Int. 2007; 79: 19-23
        • Raghavendran M
        • Rastogi A
        • Dubey D
        • et al.
        Stones associated renal pelvic malignancies.
        Indian J Cancer. 2003; 40: 108-112
        • Lei M
        • Yuan J
        • Liu YD
        • Zhang Z
        • Luo JT
        • Zhu W.
        Renal pelvic carcinoma associated with renal stone.
        Chin J Urol. 2013; 34: 485-488
        • Katz R
        • Gofrit ON
        • Golijanin D
        • et al.
        Urothelial cancer of the renal pelvis in percutaneous nephrolithotomy patients.
        Urol Int. 2005; 75: 17-20
        • Shah HN
        • Jain P
        • Chibber PJ.
        Laparoscopic nephrectomy for giant staghorn calculus with non-functioning kidneys: is associated unsuspected urothelial carcinoma responsible for conversion? Report of 2 cases.
        BMC Urol. 2006; 6: 1
        • Chung SD
        • Sun HD
        • Hung SF
        • Chiu B
        • Chen Y
        • Wu JM.
        Renal stone-associated squamous cell carcinoma and pyelo-colo-duodenal fistula.
        Urology. 2008; 72: 1013
        • Zuckerman JM
        • Passman C
        • Assimos DG.
        Transitional cell carcinoma within a calyceal diverticulum associated with stone disease.
        Rev Urol. 2010; 12: 52-55
        • Paonessa J
        • Beck H
        • Cook S.
        Squamous cell carcinoma of the renal pelvis associated with kidney stones: a case report.
        Med Oncol. 2011; 28: S392-S394
        • Verma N
        • Yadav G
        • Dhawan N
        • Kumar A.
        Squamous cell carcinoma of kidney co-existing with renal calculi: a rare tumour.
        BMJ Case Rep. 2011; 2011
        • Nakano T
        • Kitagawa Y
        • Izumi K
        • Ikeda H
        • Namiki M.
        Invasive urothelial carcinoma within a calyceal diverticulum associated with renal stones: a case report.
        Oncol Lett. 2015; 10: 2439-2441
        • Xiao J
        • Lei J
        • He L
        • Yin G.
        Renal calculus complicated with squamous cell carcinoma of renal pelvis: report of two cases.
        Can Urol Assoc J. 2015; 9: E310-E312
        • Kumar S
        • Tomar V
        • Yadav SS
        • et al.
        Primary squamous cell carcinoma of kidney associated with large calculus in non-functioning kidney: a case report.
        Urol Case Rep. 2016; 8: 4-06
        • Wu CQ
        • Matulay JT
        • Gupta M
        • Motamedinia P.
        Unsuspected malignancy during percutaneous nephrolithotomy: the snake in the grass.
        J Endourol Case Rep. 2016; 2: 184-188
        • Kivlin D
        • Tong C
        • Friedlander J
        • Perosio P
        • Simhan J.
        Sarcomatoid squamous cell carcinoma of the renal pelvis masquerading as emphysematous pyelonephritis with staghorn calculus.
        J Endourol Case Rep. 2016; 2: 87-89
        • Kondisetty S
        • Borkar PV
        • Thomas A.
        Nephrectomy for infected stag horn calculus confounded by the presence of squamous cell carcinoma.
        BMJ Case Rep. 2017; 2017
        • Hosseinzadeh M
        • Mohammadzadeh S.
        Primary pure squamous cell carcinoma of kidney associated with multiple stag horn stones.
        Int Med Case Rep J. 2020; 13: 261-263
        • Kasahara R
        • Kawahara T
        • Tajiri R
        • Uemura H
        • Kitami K.
        Renal squamous cell carcinoma with staghorn calculus.
        Case Rep Oncol. 2020; 13: 403-407
        • Tsuboi I
        • Maruyama Y
        • Araki M
        • et al.
        Advanced renal pelvic carcinoma revealed after treatment of a staghorn calculus by endoscopic combined intrarenal surgery.
        Case Rep Urol. 2020; 20209703479
        • Chang TH
        • Tseng JS.
        Rare squamous cell carcinoma of the kidney with concurrent xanthogranulomatous pyelonephritis: a case report and review of the literature.
        Open Med (Wars). 2021; 16: 128-133
        • Sivaramakrishna B
        • Aron M
        • Ansari MS
        • et al.
        Squamous cell carcinoma of the renal pelvis manifesting after percutaneous nephrolithotomy for long standing calculus.
        Int Urol Nephrol. 2004; 36: 149-151
        • Zengin K
        • Tanik S
        • Sener NC
        • et al.
        Incidence of renal carcinoma in non-functioning kidney due to renal pelvic stone disease.
        Mol Clin Oncol. 2015; 3: 941-943
        • Chow WH
        • Lindblad P
        • Gridley G
        • et al.
        Risk of urinary tract cancers following kidney or ureter stones.
        J Natl Cancer Inst. 1997; 89: 1453-1457
        • Federico A
        • Morgillo F
        • Tuccillo C
        • Ciardiello F
        • Loguercio C.
        Chronic inflammation and oxidative stress in human carcinogenesis.
        Int J Cancer. 2007; 121: 2381-2386
        • Motamedinia P
        • Keheila M
        • Leavitt DA
        • Rastinehad AR
        • Okeke Z
        • Smith AD.
        The expanded use of percutaneous resection for upper tract urothelial carcinoma: a 30-year comprehensive experience.
        J Endourol. 2016; 30: 262-267
        • Samson P
        • Smith AD
        • Hoenig D
        • Okeke Z.
        Endoscopic management of upper urinary tract urothelial carcinoma.
        J Endourol. 2018; 32: S10-S16
        • Chen HQ
        • Huang CY
        • Li SJ
        • Wang GL.
        Diagnosis and treatment of carcinoma of renal pelvis accompanied with kidney stones.
        Chin J Urol. 2010; 31: 81-83
        • Xu Y
        • Ma X
        • Ai X
        • et al.
        A urine-based liquid biopsy method for detection of upper tract urinary carcinoma.
        Front Oncol. 2020; 10597486