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Abstract
The simultaneous occurrence of a renal cell carcinoma and a urothelial carcinoma in the same kidney is uncommon. Here we report the case of a 79-year-old woman with ipsilateral synchronous renal cell carcinoma and urothelial carcinoma. She was referred to our hospital for gross hematuria and right flank pain. A computed tomography scan showed a 15x20 mm enhanced lesion on the upper calyx and a 12x15 mm mass on the lateral aspect of the right kidney. We thus suspected a renal pelvis tumor and performed right hand assisted laparoscopic nephroureterectomy with bladder cuff excision (HALSNU). Gross findings were multiple, pale yellowish papillary masses on the upper and lower major calices, of which the largest one measured 16x20 mm. A separated solid mass measuring 12x16 mm was also noted on the anterior midportion of the kidney. The former was a urothelial carcinoma and the latter was a chromophobe renal cell carcinoma. We present a rare case of a chromophobe renal cell carcinoma and a urothelial carcinoma in the same kidney.
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Fig. 1
Abdominal CT scan showed a 12 mm mass on the lateral aspect, chromophobe renal cell carcinoma, and 15x20 mm mildly enhancing mass (arrow), urothelial carcinoma, on the upper calyx of the right kidney (B).
Fig. 2
(A) A well-circumscribed solid mass (arrow) measuring 16x12 mm on the mid portion of the right kidney is noted (H&E, x12.5) (Inlet) The tumor cells revealed a high nuclear grade (Fuhrman nuclear grade 4) of chromophobe renal cell carcinoma (H&E, x200) (B) Multiple papillary urothelial carcinomas, high grade, are found on the upper and lower calyx, which were not invading the subepithelium (H&E, x40).
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