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UROLOGICAL IMAGES
Year : 2016  |  Volume : 32  |  Issue : 1  |  Page : 79-80
 

Transitional cell carcinoma: A rare development in congenital ureteropelvic junction obstruction kidney


Department of Urology, V. M. Medical College and Safdarjang Hospital, New Delhi, India

Date of Web Publication4-Jan-2016

Correspondence Address:
Pawan Vasudeva
Department of Urology, V.M. Medical College and Safdarjang Hospital, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.173106

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   Abstract 

A 54-year-old male chronic smoker presented with hematuria 13 years after being diagnosed with an asymptomatic left non-functioning kidney secondary to congenital ureteropelvic junction obstruction. On evaluation, he was diagnosed with renal collecting system mass occupying the lower pole region, for which radical nephroureterectomy with bladder cuff excision and nodal dissection was carried out. Histopathology revealed upper tract transitional cell carcinoma.


Keywords: Non-functioning kidney, transitional cell carcinoma, ureteropelvic junction obstruction


How to cite this article:
Vasudeva P, Kumar N, Kumar A. Transitional cell carcinoma: A rare development in congenital ureteropelvic junction obstruction kidney. Indian J Urol 2016;32:79-80

How to cite this URL:
Vasudeva P, Kumar N, Kumar A. Transitional cell carcinoma: A rare development in congenital ureteropelvic junction obstruction kidney. Indian J Urol [serial online] 2016 [cited 2019 Sep 22];32:79-80. Available from: http://www.indianjurol.com/text.asp?2016/32/1/79/173106



   Introduction Top


A 54-year-old male, chronic smoker was diagnosed with an asymptomatic non-functioning left kidney secondary to congenital ureteropelvic junction obstruction (UPJO) during routine health check up 13 years earlier. He refused surgical intervention and was lost to follow-up till 10 months back, when he presented with gross painless hematuria. Physical examination revealed a 15 cm × 15 cm left renal lump, urinalysis showed 100 RBCs/HPF and urine cytology was negative for malignant cells. Computed tomography (CT) urography revealed left gross hydronephrosis with abrupt cut-off at PUJ with thinned out renal parenchyma and an 8 cm × 7 cm × 6 cm enhancing soft tissue mass occupying the collecting system in the lower pole region [Figure 1]. Radical nephroureterectomy with bladder cuff excision was performed with lymph node dissection from the renal hilum to the aortic bifurcation [Figure 2] left]. Histopathology revealed high-grade transitional cell carcinoma (TCC) (stage pT4, N0, M0) [Figure 2] right]. The patient is asymptomatic on follow-up.
Figure 1: Computed tomography scan demonstrating renal collecting system tumor; left – coronal view, right – sagittal view

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Figure 2: Radical nephroureterectomy specimen; left – opened-up specimen showing tumor, right – high-grade transitional cell tumor present as disorganized sheets of cells with a high nuclear cytoplasmic ratio

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Upper urinary tract TCC was reported in non-functioning kidney secondary to (a) Stone disease and (b) congenital UPJO with calcified renal pelvis.[1],[2] While TCC/squamous cell carcinoma of the renal pelvis presenting as UPJO is well documented, TCC developing in a kidney with UPJO is extremely rare, with only few cases having been reported.[3],[4],[5]

 
   References Top

1.
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.  Back to cited text no. 1
    
2.
Gold RP, Saitas V, Pellman C. Congenital ureteropelvic junction obstruction with calcified renal pelvis and superimposed spindle cell urothelial carcinoma. Urol Radiol 1990;12:15-7.  Back to cited text no. 2
    
3.
Mediavilla E, Ballestero R, Correas MA, Gutierrez JL. About a case report of giant hydronephrosis. Case Rep Urol 2013;2013:257969.  Back to cited text no. 3
    
4.
Chiang PH, Chen MT, Chou YH, Chiang CP, Huang CH, Chien CH. Giant hydronephrosis: Report of 4 cases with review of the literature. J Formos Med Assoc 1990;89:811-7.  Back to cited text no. 4
    
5.
Sangisetty KV, Randrup ER. Congenital giant hydronephrosis with unsuspected transitional cell carcinoma. Urology 1985;26:400-1.  Back to cited text no. 5
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