CASE N°27 – Renal Papillary Urothelial Carcinoma
Hematuria and left flank pain.
Ultrasound: Renal parenchyma within the limits, not dilated urinary tract bilaterally
Cytological speciemen: Renal Washing
Positive for malignancy: numerous pseudo-papillary aggregates of malignant cells, transitional type.
Histological speciemen: Renal Biopsy
Papillary Urothelial Carcinoma, high grade
Renal pelvis tumors account for 5-10% of all renal tumors and about 5% of urothelial tumors. Rarely occur before age 40, with a peak incidence between the 6th-7th decade and an average age of 65 years.
Histologically, 90% are transitional forms, the 0.7-7% squamous cell carcinoma, adenocarcinoma 1%.
It should be noted that in 2-4% of cases, the lesion is synchronous or metachronous contralateral lesions of the urinary tract, and 30-50% of the lesions was followed by a pathology of urothelial bladder.
A significant increase in the risk of developing urothelial tumors or pelvic has been reported in workers in chemical, petrochemical and plastics, and in workers exposed to coal, asphalt and bitumen.
The most common symptom is the total gross hematuria, which occurs in 75% of cases.
The flank pain is found in 30% of patients
Ultrasound: for the tumors located in the upper urinary tract it has a diagnostic value significantly lower than urography, as in this case.
Urography: 50-70% of patients had a filling defect