Stones associated renal pelvic malignancies.
BACKGROUND
The clinico-pathological characteristics of renal pelvic malignancies associated with stones were retrospectively analyzed.


OBJECTIVE
The main objective was to define the biological behavior and prognostic factors for these malignancies.


METHODS
The tumors were classified according to the pathological types. The clinical data, imaging features and pathological features were analyzed with relation to prognosis.


METHODS
Eighteen cases of malignancies associated with stone disease were retrospectively studied. The institute review board permitted the study.


RESULTS
High incidence (15/18) of squamous cell carcinoma (SCC) was noted. The prognosis in this group of patients was uniformly poor. The median survival time was 3.6 months in the SCC group, 7.5 months in the Transitional Cell Carcinoma (TCC) group and 24 months in the Adenocarcinoma (AC) group. Infectious and systemic symptoms were noted in the majority of the patients. Preoperative Imaging techniques revealed tumor in only 2 cases. Both underwent radical extirpation and the median survival is 18 months till date. In the other 16 patients, where the initial diagnosis was made only on histological analysis of incomplete nephrectomy specimens, the survival was 3.56 months. All patients had prolonged history of staghorn stone disease with associated non-functioning kidney. We found that the main prognostic factor was the stage of the disease.


CONCLUSIONS
Malignancies associated with stone disease have insidious onset of clinical symptoms and need a high degree of suspicion to identify them pre-operatively. The grave prognosis associated with incomplete excision makes it imperative to diagnose them earlier.
Raghavendran
M
M
Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rae Bareli Road, Lucknow - 226 014, India.
Rastogi
A
A
Dubey
D
D
Chaudhary
H
H
Kumar
A
A
Srivastava
A
A
Mandhani
A
A
Krishnani
N
N
Kapoor
R
R
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000473:pathology*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D007682:Kidney Pelvis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed