Indian Journal of Urology
CASE REPORT
Year
: 2000  |  Volume : 16  |  Issue : 2  |  Page : 152--153

Transitional cell carcinoma of renal pelvis associated with primary uretero計elvic junction obstruction


NP Rangnekar, MD Sanzgiri, VV Maste, Imdad Ali, HR Pathak 
 Department of Urology, Topiwala National Medical College & B. Y Nair Charitable Hospital, Mumbai, India

Correspondence Address:
H R Pathak
Department of Urology, B.Y.L. Nair Charitable Hospital, Mumbai Central, Mumbai - 400 008
India




How to cite this article:
Rangnekar N P, Sanzgiri M D, Maste V V, Ali I, Pathak H R. Transitional cell carcinoma of renal pelvis associated with primary uretero計elvic junction obstruction.Indian J Urol 2000;16:152-153


How to cite this URL:
Rangnekar N P, Sanzgiri M D, Maste V V, Ali I, Pathak H R. Transitional cell carcinoma of renal pelvis associated with primary uretero計elvic junction obstruction. Indian J Urol [serial online] 2000 [cited 2020 Jan 26 ];16:152-153
Available from: http://www.indianjurol.com/text.asp?2000/16/2/152/22216


Full Text

 Introduction



We report an unusual case of giant hydronephrosis due to primary uretero-pelvic junction obstruction associated with transitional cell carcinoma of renal pelvis.

 Case Report



A 35-year-old man presented with intermittent dull ache in the left loin, which was associated with intermittent development of lumbar lump since 2 years. He also gave history of one episode of painless, profuse haematuria, not associated with loin pain of recent onset. Physical ex苔mination and renal biochemistry was normal.

IVU revealed non-visualization of left pelvi-calyceal system, but multiple radio-opaque densities in left renal region. Ultrasound of bladder was normal and that of kid要ey showed evidence of huge hydronephrotic sac on the left side with no cortex. It contained multiple small cal苞uli with papillary mucosal growth arising from the pel赳is. Left ureter was undilated. Right kidney and ureter were normal.

Plain and contrast CT scan of the abdomen and pelvis revealed evidence of papillary tumour in the left renal pelvis that was not infiltrating outside the walls of the pel赳is. There was no regional lymphadenopathy seen [Figure 1].

The patient was operated for left radical nephroureterec負omy. Gross specimen revealed multiple papillary fronds ranging from 0.5-2 cms, in diameter in the renal pelvis away from UPJ, which was not involved by the tumour. Histopathological sections confirmed the presence of papillary transitional cell carcinoma of the renal pelvis with moderate anaplasia and brisk mitoses [Figure 2]. UPJ showed evidence of muscular hypertrophy and fibrosis with no infiltration of the tumour.

 Comment



This is an unusual association of primary UPI obstruc負ion with transitional cell carcinoma. Cases of squamous metaplasia and squamous cell carcinoma asociated with primary UPJ obstruction have been reported. [1] To our knowledge there is a reported case of pelvic TCC, but in association with squamous cell carcinoma in case of giant hydronephrosis, [2] and another of pelvic TCC causing UPJ obstruction and giving rise to intermittent hydronephro貞is. [3] We are unaware of any reported case of association of TCC with idiopathic primary UPJ obstruction.

References

1Chiang PH. Chen MT, Chou YH, Chiang CP. Chien CH. Giant hy苓ronephrosis: Report of our cases with review of literature. Journal of the Formosan Medical Association (J Formos Med Assoc) 1990; 89: 811-817.
2Sakamoto A, Tsuchiyama H, Honda K. Taiwan I Hsuch Hui Tsa Chih. Squamous cell carcinoma of the renal pelvis associated with giant hydronephrosis - report of an autopsy case. Japanese Journal of Cancer Clinics (Jap J Cancer Clin) 1986; 32: 1901-1907.
3English PJ. Williams G, Carroll RNP. Intermittent hydronephrosis due to transitional cell carcinoma of the renal pelvis. Br. J Urol 59: 94 1987; 59: 94-95.