A high association of upper urinary tract transitional cell carcinoma with nonfunctioning kidney caused by stone disease in Taiwan.
BACKGROUND
Although many studies have reported that upper urinary tract stones in patients with nonfunctioning kidneys are associated with malignancy, the incidence and frequency of the tumor cell type remain unclear. Therefore, we aimed to investigate the percentage of malignancies present in patients with nonfunctional kidneys who underwent nephrectomy.


METHODS
From July 1995 to December 2005, we reviewed a total of 47 patients who underwent nephrectomy to treat a nonfunctional kidney due to urolithiasis with clinical symptoms such as complicated chronic infection. Pathology revealed malignancies in 24 patients. Relationships between clinical presentations and malignancy were analyzed.


RESULTS
Malignancy was diagnosed in 24 patients after nephrectomy. Image studies revealed possible malignancy in only 7 patients before surgery. A high incidence (17/24) of transitional cell carcinoma was noted. The remaining malignancies included 5 renal cell carcinomas, 1 squamous cell carcinoma and 1 epidermoid carcinoma. There were 5 deaths during the follow-up interval.


CONCLUSIONS
There is a high incidence of malignancy associated with nonfunctional kidney caused by stone disease. We suggest careful examination of the pathological specimens from nephrectomy for nonfunctional kidney regardless of clinical manifestations.
Yeh
Chin-Chung
CC
Department of Urology, China Medical University Hospital, Taichung, Taiwan, ROC.
Lin
Tien-Huang
TH
Wu
Hsi-Chin
HC
Chang
Chao-Hsiang
CH
Chen
Chia-Chen
CC
Chen
Wen-Chi
WC
D002295:Carcinoma, Transitional Cell / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications* / Q000601:surgery; D007680:Kidney Neoplasms / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D014516:Ureteral Neoplasms / Q000150:complications* / Q000453:epidemiology