|Year : 2004 | Volume
| Issue : 2 | Page : 172-174
Mucinous cystadenocarcinoma of renal pelvis - a case report
Vinay A Chougule, KR Babli, Mukund G Andankar, Sandhya R Rao, Hemant R Pathak
Department of Urology, TN.Medical College and B.Y.L. Nair Hospital, Mumbai, India
Hemant R Pathak
Department of Urology, TN Medical College and BYL Nair Hospital, Mumbai Central, Mumbai - 400 008
Source of Support: None, Conflict of Interest: None
Keywords: Cystadenocarcinoma, renal pelvis
|How to cite this article:|
Chougule VA, Babli K R, Andankar MG, Rao SR, Pathak HR. Mucinous cystadenocarcinoma of renal pelvis - a case report. Indian J Urol 2004;20:172-4
| Case Report|| |
A 35-year-old female presented with history of continuous, dull ache on the right side of abdomen for 2 years. She also noticed a slowly increasing mass on the right side 4 months back. She had undergone right-sided pyelolithotomy twice, 5 years and 2 years earlier.
On examination a firm, bimanually palpable lump, extending from the right hypochondrium to the right iliac fossa was noticed. No other significant finding was noted. X-ray KUB region showed a 1 cm radio-opaque density in the right renal region. On ultrasonography a cystic, septate mass, 12 x 20 cm in size extending from the liver to the iliac fossa was seen with no obvious renal tissue. Contrast enhanced computerized tomography of the abdomen and pelvis confirmed a non-enhancing 12 x 15 x 20 cm cystic mass, extending from the liver to the right iliac fossa eroding the iliac crest.
The retroperitoneal mass was explored through a 11 th rib bed incision. It was cystic, adherent on all sides and it ruptured during mobilization with a gush of almost 1 1 of gelatinous material coming out. The mass was removed completely. Gross examination revealed a kidney with a dilated, thin walled pelvicalyceal system and cystic spaces filled with mucinous material [Figure - 1]. Histopathological examination revealed a mucin secreting glandular epithelium with large hyperchromatic nuclei without fibrotic reaction suggestive of mucinous cystadenocarcinoma of the renal pelvis [Figure - 2].
| Comments|| |
Mutinous cystadenocarcinoma of the renal pelvis is a very rare condition with only 95 cases reported so far. 
Mucinous cystadenocarcinoma of the renal pelvis is a very rare tumour comprising less than 0.3% of total renal pelvic tumours.  The etiology is thought to be due to the unique ability of transitional epithelium to respond with a glandular metaplastic change due to chronic infection or irritation; this metaplasia may occasionally initiate glandular tumours. Terris et al reported a case of mucinous adenocarcinoma of the renal pelvis and ureter presenting as chronic flank pain, calculus and hydronephrosis in an immigrant from India. They report a literature review suggesting a high frequency of this otherwise rare tumour in India with an inflammatory, environmental or dietary etiology. 
Usual features of this tumour include long duration of symptoms, association with calculi and hydronephrosis and a preoperative appearance of an inflammatory condition. The occurrence of this tumour, though rare, should be kept in mind especially if a renal mass lesion is associated with recurrent calculus disease. 
This tumour is classically treated by radical excision with postoperative chemotherapy. However, it has a very poor prognosis.
| References|| |
|1.||Ueda T, Okumi M, Fujimoto N. Mucinous adenocarcinoma of renal pelvis in the horseshoe kidney. Hinyokika kiyo 2002; 48(3): 187-9 (Article in Japanese). |
|2.||Kakkar N, Joshi K, Mandal AK. Mucinous adenocarcinoma of the renal pelvis. Ind J Pathol Micro 1997; 40: 393-5. |
|3.||Terris MK, Anderson RU. Mucinous adenocarcinoma of renal pelvis in natives of India. Urol Int 1997; 58(2): 121-3. |
[Figure - 1], [Figure - 2]