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Transitional cell carcinoma within a calyceal diverticulum associated with stone disease
Jack M Zuckerman1, Corey Passman, Dean G Assimos
1Department of Urology, Wake Forest University School of Medicine Winston-Salem, NC.
Reviews in Urology
|April 30, 2010
Summary
Transitional cell carcinoma (TCC) can develop in kidney calyceal diverticula containing stones. This case showed both low-grade and high-grade TCC within the same kidney, highlighting diagnostic and treatment challenges.
Area of Science:
- Urology
- Oncology
- Nephrology
Background:
- Transitional cell carcinoma (TCC) can occur in the upper urinary tract.
- Calyceal diverticula are rare renal anomalies often associated with calculi.
- The association between calyceal diverticula, stones, and TCC is not well-established.
Purpose of the Study:
- To report a unique case of TCC discovered within a calyceal diverticulum.
- To highlight the potential for TCC development in stone-laden calyceal diverticula.
- To illustrate the possibility of coexisting different grades of TCC in the renal unit.
Main Methods:
- A patient presenting for percutaneous nephrolithotomy for calyceal diverticular stones.
- Endoscopic removal of stones and tumor, followed by fulguration of the diverticular cavity.
- Subsequent laparoscopic radical nephroureterectomy for further evaluation and treatment.
Main Results:
- Low-grade TCC was found within the calyceal diverticulum.
- Pathologic analysis after nephroureterectomy revealed high-grade TCC invading the renal parenchyma.
- The case demonstrated TCC arising in a stone-containing calyceal diverticulum.
Conclusions:
- Calyceal diverticula with stones represent a potential site for TCC development.
- Different grades of TCC can coexist within the same renal unit.
- This case underscores the importance of considering malignancy in patients with complex calyceal diverticula and stones.
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