Primary Squamous Cell Carcinoma of the Kidney Associated with Multiple Staghorn Calculi: A Case Report.
Primary squamous cell carcinoma (SCC) of the kidney is an extremely rare malignancy, usually originating from the renal pelvis due to continuous irritation from infections and nephrolithiasis. However, it can also arise from parenchyma. It has rarely been reported in the literature. Renal squamous cell carcinoma often presents late with nonspecific symptoms such as flank pain and hematuria. It is typically linked to kidney stones, and because of its nonspecific clinical symptoms and radiological characteristics, patients often seek medical attention only in the advanced stages of the disease. This kidney neoplasm is aggressive in nature and usually has a poor prognosis. Most patients present with an advanced stage of the disease, and it has an unfavorable outcome. In this report, we cover a case of primary squamous cell carcinoma with staghorn kidney stones in a 70-year-old patient.
The present case is a 70-year-old man who presented to the Emergency Department of Ali Abad Teaching Hospital, Kabul, with complaints of flank pain and anorexia. The hospital performed laboratory, ultrasound, and histopathological examinations. Ultrasound showed an enlarged kidney with several staghorn stones, and pus was noted in the renal collecting system. The patient underwent laparotomous radical nephrectomy due to suspicion of renal cell carcinoma. Histopathological examinations showed evidence of keratin pearl formation, stromal invasion, and areas of necrosis, supporting the diagnosis of renal squamous cell carcinoma. No clinically apparent primary tumor was identified outside the kidney. The patient was then referred to the oncology department. Despite appropriate medical therapy, the patient died after 2 months of follow-up.
Primary squamous cell carcinoma of the kidney is a rare and highly aggressive malignancy strongly associated with chronic nephrolithiasis. Early detection remains challenging due to nonspecific clinical and radiological features. Clinicians should consider the possibility of renal squamous cell carcinoma in patients presenting with renal masses, nephrolithiasis, and flank pain. Also, this malignancy should remain a differential diagnosis of xanthogranulomatous pyelonephritis in patients with persistent kidney stone disease. It is often diagnosed postoperatively after nephrectomy.
The present case is a 70-year-old man who presented to the Emergency Department of Ali Abad Teaching Hospital, Kabul, with complaints of flank pain and anorexia. The hospital performed laboratory, ultrasound, and histopathological examinations. Ultrasound showed an enlarged kidney with several staghorn stones, and pus was noted in the renal collecting system. The patient underwent laparotomous radical nephrectomy due to suspicion of renal cell carcinoma. Histopathological examinations showed evidence of keratin pearl formation, stromal invasion, and areas of necrosis, supporting the diagnosis of renal squamous cell carcinoma. No clinically apparent primary tumor was identified outside the kidney. The patient was then referred to the oncology department. Despite appropriate medical therapy, the patient died after 2 months of follow-up.
Primary squamous cell carcinoma of the kidney is a rare and highly aggressive malignancy strongly associated with chronic nephrolithiasis. Early detection remains challenging due to nonspecific clinical and radiological features. Clinicians should consider the possibility of renal squamous cell carcinoma in patients presenting with renal masses, nephrolithiasis, and flank pain. Also, this malignancy should remain a differential diagnosis of xanthogranulomatous pyelonephritis in patients with persistent kidney stone disease. It is often diagnosed postoperatively after nephrectomy.
Authors
Marofi Marofi, Kamal Kamal, Sediqi Sediqi, Bawarzai Bawarzai, Sarwary Sarwary, Modabber Modabber
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