Case presentation A 72 year-old female presented to the ED with 4 weeks of gradually worsening left upper and lower quadrant pain. [ncbi.nlm.nih.gov]

The rarity of this metastatic tumour, with its unusual presentation, is discussed. [casereports.bmj.com]

• Sputum

  Chest x-ray, sputum cytology, CT of the chest Lung cancer Prospective studies have yielded conflicting results for any method of screening for lung cancer in smokers, and the costs of screening, e.g., with computed tomography of the chest, may be prohibitive [medical-dictionary.thefreedictionary.com]

• Abdominal Tenderness

  Physical examination was normal except for left-sided abdominal tenderness. Ultrasonography revealed hydronephrosis. Intravenous pyelography showed a functioning kidney with a slight left hydronephrosis and multiple calculi in the lower calyx. [jcytol.org]

  There was abdominal tenderness in the left flank area with no palpable mass. Investigations revealed normal CBC, coagulation, renal functions, electrolytes, bone profile LFT, and chest X-ray. HIV 1 and 2 were negative. [urotoday.com]

• Upper Abdominal Pain

  For 2 months prior to admission, she had had intermittent right upper abdominal pain, vomiting, constipation, anorexia and significant weight loss. [karger.com]

• Jaundice

  Jaundice is common. The liver is enlarged, its surface is nodular, and a central depression or umbilications can often be detected. LUNG CANCER: Lung cancer seen endoscopically. [medical-dictionary.thefreedictionary.com]

• Homans' Sign

  She had nonpitting edema on both legs that was more pronounced on the right leg with the presence of Homan's sign. Deep vein thrombosis was suspected. [karger.com]

• Hematuria

  The two patients with gross hematuria were diagnosed with a tumor in preoperative imaging (CT) and underwent radical nephrectomy. [synapse.koreamed.org]

  […] et al., 1990 (6) 66, F Intermittent hematuria, tiredness. [npplweb.com]

  History goes back to 4 months prior to his presentation, when he started complaining of intermittent gross hematuria, associated with left flank pain without fever or chills. [imedpub.com]

  Symptoms include hematuria and sometimes pain. Diagnosis is by CT, cytology, and sometimes biopsy. Treatment is surgery. TCC of the renal pelvis accounts for about 7 to 15% of all kidney tumors. [msdmanuals.com]

After proper workup, large calculus with heterogeneous density mass detected in nonfunctioning left kidney. After radical nephrectomy, histopathological examination revealed squamous cell carcinoma of renal pelvis. [ncbi.nlm.nih.gov]

Sudden onset of similar diffuse cutaneous lesions should elicit serious consideration for paraneoplastic disease and further workup to evaluate for an underlying cancer. [austinpublishinggroup.com]

Recent workup demonstrated a complex 6.5 cm mass arising from the lower pole of her atrophic left kidney. [ijpmonline.org]

SCC may be associated with paraneoplastic syndrome; [10] however, the laboratory workup of our patients did not show any abnormal results. [urologyannals.com]

Authors’ contributions All the authors contributed to the workup of the patient including clinical evaluation, investigation, and treatment planning. The manuscript has been reviewed and approved by all the authors. [jmedicalcasereports.biomedcentral.com]

• Right Pleural Effusion

  Thrombosis completely occluded the right leg and partially the left leg. There was minimal right pleural effusion on chest X-ray, with no abnormal pulmonary nodules. [karger.com]

  X-ray Chest (postero-anterior view) depicted right pleural effusion. Trucut biopsy of the mass confirmed it as moderately differentiated SCC (cT4N2M1). In view of the grave prognosis, the patient and his relatives were psychologically counseled. [omicsonline.org]

• Pleural Effusion on Chest X-Ray

  There was minimal right pleural effusion on chest X-ray, with no abnormal pulmonary nodules. In searching for the primary site of malignancy, a left supraclavicular lymph node biopsy was performed. [karger.com]

• Dyslipidemia

  Her medical conditions were hypertension and dyslipidemia, and she was receiving treatment with amlodipine and simvastatin. She was a passive smoker and did not drink alcohol. There was no history of malignancy in her family. [karger.com]

• Creatinine Decreased

  The most common (≥20%) lab abnormalities occurring in patients receiving INLYTA (all grades, vs sorafenib) included increased creatinine, decreased bicarbonate, hypocalcemia, decreased hemoglobin, decreased lymphocytes (absolute), increased ALP, hyperglycemia [pfizer.com]

Therefore, most patients should require treatment of staghorn stones. The treatment options are medical therapy, surgery, percutaneous nephrolithotomy and shock wave lithotripsy. [karger.com]

Radical surgical resection is the foremost treatment option, as alternative treatments are of limited efficacy. [ncbi.nlm.nih.gov]

Treatment options under clinical evaluation: The development of new instrumentation for endourological treatment of upper tract transitional cell cancer has provided new options for regional management of these cancers. [cancer.gov]

New treatment modalities are urgently needed to improve the poor prognosis in patients with advanced stage squamous cell carcinoma and urothelial carcinoma of the upper urinary tract. [nebraska.pure.elsevier.com]

There are still no standard treatments for SCC of the renal pelvis. Some literature suggests the primary treatment of renal pelvic SCC is nephrectomy. [tro.amegroups.com]

Conclusions: The prognosis for squamous cell carcinoma is poor, but stage for stage the prognosis is not different between patients with urothelial carcinoma and squamous cell carcinoma of the renal pelvis and ureter. [nebraska.pure.elsevier.com]

Squamous cell carcinoma of the renal pelvis has a grave prognosis. Humoral hypercalcemia of malignancy mediated by PTH-rP is an uncommon feature of the tumor. [karger.com]

Because of advanced stage at presentation, the prognosis is generally poor, as surgical resection is rarely curative and adjuvant chemoradiotherapy is usually ineffective. [ncbi.nlm.nih.gov]

[…] case also, no such etiological factor could be identified. [cancerjournal.net]

Etiological factors are renal calculi, infection, endogenous and exogenous chemicals, hormonal imbalance, and vitamin A deficiency, although it occurs without any etiological factors [3]. [hindawi.com]

[…] squamous differentiation Epidemiology Very rare tumor, except for patients with nonfunctioning hydronephrotic kidney due to renal pelvic stone disease ( Mol Clin Oncol 2015;3:941 ) Approximately equal men and women, age 50 - 70 years ( J Urol 2007;178:51 ) Etiology [pathologyoutlines.com]

Human, Hydronephrosis, epidemiology,etiology,India, epidemiology,Kidney Calculi, epidemiology,etiology,Kidney Neoplasms, complications,epidemiology,pathology,surgery,ultrastructure,Kidney Pelvis, Male, Middle Age, Nephrecto How to cite this article: [jpgmonline.com]

Various etiological features have been held responsible for squamous metaplasia and subsequent carcinoma. Of these, renal calculi and infection are the leading ones. [ccij-online.org]

Hematuria, epidemiology,etiology,Human, Hydronephrosis, epidemiology,etiology,India, epidemiology,Kidney Calculi, epidemiology,etiology,Kidney Neoplasms, complications,epidemiology,pathology,surgery,ultrastructure,Kidney Pelvis, Male, Middle Age, Nephrecto [jpgmonline.com]

Epidemiology of cancer of the renal pelvis and ureter.J Natl Cancer Inst. 1974; 52: 1431 PubMed Google Scholar Konno S. Tanaka J. Eto K. [goldjournal.net]

"Lessons Learned from the Global Epidemiology of Kidney Cancer: A Refresher in Epidemiology 101". European Urology. 75 (1): 85–87. doi:10.1016/j.eururo.2018.09.035. PMID 30274700. [en.wikipedia.org]

[…] urothelial differentiation (invasive or in situ) and not combined with another renal neoplasm Terminology Cases with associated urothelial carcinoma or urothelial carcinoma in situ are best classified as urothelial carcinoma with squamous differentiation Epidemiology [pathologyoutlines.com]

The issue of synergistic effects can be appropriately addressed by epidemiological studies that show stratified analysis and have sufficient power. [greenfacts.org]

Other risk factors include race, age, sex, bladder birth defects, genetics, long-term chemotherapy with cyclophosphamide, pelvic radiation, and having taken pioglitazone for diabetes for more than 1 year. 3 Pathophysiology Non–muscle invasive disease [onclive.com]

References Healy KA, Ogan K: Pathophysiology and management of infectious staghorn calculi. Urol Clin North Am 2007;34:363-374. [karger.com]

Pathophysiology TCC accounts for more than 90% of renal pelvic tumors; other cancer types seen include squamous cell carcinoma (SCC) and adenocarcinoma. [emedicine.medscape.com]

Treatment is essentially preventive by removal of staghorn calculi and management of chronic urinary tract infections. [ncbi.nlm.nih.gov]

Removal of the staghorn stone is necessary to eliminate infection and prevent squamous metaplasia of the renal epithelium. [karger.com]

This emphasizes the need of early treatment of nephrolithiasis to prevent the development of SCC and screening of patients with long standing staghorn calculi. [ FULL TEXT ] | [ PDF ] [jcdr.net]

Neoadjuvant chemotherapy prior to nephroureterectomy is recommended for high grade and high stage lesions because other treatments can decrease renal function, often preventing subsequent use of adjuvant chemotherapy. [msdmanuals.com]