Indian Journal of Urology
CASE REPORT
Year
: 2002  |  Volume : 18  |  Issue : 2  |  Page : 186--187

Skeletal metastasis as primary presentation of squamous cell carcinoma of renal pelvis


Arun Chawla, Mahesh Rao, Sridhar Reddy, SJ Philipraj, K Sasidharan 
 Division of Urology, Kasturba Medical College, Manipal, India

Correspondence Address:
K Sasidharan
Division of Urology, KMC, Manipal, Karnataka - 576 119
India




How to cite this article:
Chawla A, Rao M, Reddy S, Philipraj S J, Sasidharan K. Skeletal metastasis as primary presentation of squamous cell carcinoma of renal pelvis.Indian J Urol 2002;18:186-187


How to cite this URL:
Chawla A, Rao M, Reddy S, Philipraj S J, Sasidharan K. Skeletal metastasis as primary presentation of squamous cell carcinoma of renal pelvis. Indian J Urol [serial online] 2002 [cited 2020 Aug 12 ];18:186-187
Available from: http://www.indianjurol.com/text.asp?2002/18/2/186/37642


Full Text

 Introduction



Squamous cell carcinoma is a very infrequent tumour afflicting the kidney. The disease spreads locally and sec­ondary deposits to the bone hardly ever occur. Bony sec­ondaries presenting as initial presentation of squamous cell carcinoma of pelvis is extremely rare. Herein we present such a case.

 Case Report



A 60-year-old male presented with history of pain and progressive limitation of movements of left shoulder of 2­months' duration. The patient volunteered no urological symptoms. The patient was well preserved and general systemic examination and routine laboratory investigations were unremarkable. Orthopaedic evaluation disclosed re­stricted abduction and rational movements of left shoul­der joint. Radiograph of the shoulder showed decreased scapular density proximate to the joint [Figure 1]. Aspirated synovial fluid was hemorrhagic and yielded malignant cells and synovial membrane biopsy was consistent with that of squamous cell carcinomatous deposit [Figure 2]. Primary renal malignancy was suspected and subsequent ultrasound revealed readily a heterogeneous mass of 6 x 5.5 cm at the interpolar and upper pole of the right kidney. IVU disclosed a non-visualized and calculi containing right kidney. Fur­ther characterization of the lesion with CT demonstrated an enhancing heterogeneous and irregular soft tissue density mass with areas of necrosis [Figure 3].

Right radical nephrectomy and local external radiation to the left shoulder has provided the patient good quality palliation till date.

 Comments



Squamous cell carcinoma of the pelvis is uncommon. Symptoms usually relate to local or locally advanced dis­ease. Bony metastasis in squamous cell carcinoma of pel­vis is rare and primary presentation with bony metastasis with silent primary tumour is even more rare. [1] Literature survey highlights only one case with skull metastasis in a patient of squamous cell carcinoma renal pelvis. [2] This case is reported for its extremely rare and uncharacteristic clini­cal presentation.

References

1Blacher EJ. Johnson DE, Abdul-Karim FW. Ayala AG. Squamous cell carcinoma of renal pelvis. Urology 1985: 25: 124-126.
2Li MK. Cheung WL. Squamous cell carcinoma of the renal pelvis. J Urol 1987: 138: 269-271.