An Interesting Case of Long-Standing Renal Calculi Associated Squamous Cell Carcinom

Abstract

A 55-year-old male patient presenting with an episode of seizure and a history of on-and-off abdominal pain since the past few years came for radiological evaluation. Initial ultrasound showed a grossly enlarged hydronephrotic right kidney with multiple large calculi and retroperitoneal lymphadenopathy. The patient underwent FAPI PET-CT to rule out malignancy and was diagnosed with long-standing renal calculi associated squamous cell carcinoma with brain, lung, and retroperitoneal lymph node metastases. Histopathology and immunohistochemistry confirmed the diagnosis of squamous cell carcinoma. The patient later underwent radical nephrectomy with retroperitoneal lymph node clearance. Adjuvant chemotherapy and radiotherapy were also administered to the patient, and he is currently on follow-up. Nonetheless, the prognosis for individuals suffering from renal pelvic squamous cell carcinoma is extremely dismal, with a median survival of barely 7 months following surgery and a mere 7.7% of patients surviving for more than 5 years.^[1]

It is acknowledged that one of the primary carcinogenic factors for SCC is urinary calculi, which causes persistent irritation of the renal pelvis, resulting in squamous metaplasia and then finally neoplasia.^[2] Patients with renal SCC have explored a variety of therapies. The patient's age, overall health, cancer staging, and patient compliance should all be taken into consideration while choosing a treatment plan. The primary treatment options for renal SCC are radical nephrectomy combined with total ureterectomy.^[3]

The goal of this article is to make the physicians aware of the possibility of renal squamous cell carcinoma in patients who have long-standing hydronephrosis or nephrolithiasis.