Abstract

Background: SCC of Renal pelvis are rare in clinical practice and patholoyl. We report a case with clinicopathological correlation of SCC in Hospital C Da Nang.

Objective: To demonstrate on unusual and aggressive of SCC .The discusses the clinical and and radiological features.

Methods : We review the clinical and pathological record of a case RSCC in retrospective of nephrectomy specimens and follow up the patient from Oct/2018 to Jan/2019 and approprivate literatures.

Case report: A 78 years old malepresented with history of renal stone operation ten years ago. The patient admitted with flank,abdominal pain and hematuria.Family history and physical examination were within normal limits. Ultrasound examination of abdomen showed left renal calculi, KUB and UIV which reveals only calculi and hydronephrosisAbdominal CT reveals a left renal pelvis mass, calculis and large lymph nodes. The patient underwent a left radical nephrectomy without complications. Histopathological examination revealed features of well - differentiated squamous cell carcinoma of renal with extensive involvement of renal parenchyma and metastasis to lymph nodes.Due to aggressive nature of these tumour patient develop locally recurrence and disseminated metastatic disease. The patients was dead four month after pathologic diagnosis. Primary SCC of renal pelvis is rare, which represents only 0.5 to 15% of malignant renal tumor. Few such cases have been reported. Nephrolithiasis, especially formation of staghorn stone was accepted as a main carcinogenic risk factor SCC. Chronic irritation, inflammation and infection are believed to induce reactive change in the urothelium and leads to neoplasia via metaplasia and leucoplasia. Initial diagnosis of SCC is based on histopathological examination. The histopathology is the hallmark of diagnosis because of lack of characteristic clinical and imaging features. Most of these SCC are moderately or presented with advance stage. The current primary treatment of renal SCC is nephrectomy, adjuvant chemotherapy or radiotherapy indicated in metastatic disease. However, it is highly aggressive unfavorable outcome, suggesting very poor prognosis, with a median survival of 3.5 months in cases of metastatic dissemination; 7 months post operatively and a dismal 5 years survival rate 7.7%.

Conclusion: Primary SCC of renal pelvis is a rare aggressive tumor with poor prognosis. The patient with newer imagingteachnologies for early detaction of the tumor that may lead to better outcome for the patients Histopathology is the hallmark of diagnosis which is usually made after surgical resection.