Ipsilateral synchronous neoplasms of kidney presenting as acute pyelonephritis and bladder metastasis.
Ipsilateral multiple synchronous primary renal neoplasms is an uncommon presentation, and only a few cases have been reported in published studies. We report the case of a 57-year-old woman with acute pyelonephritis as the initial presentation, in whom conservative treatment had no effect. Surgical intervention revealed the presence of concomitant renal cell carcinoma, collecting duct carcinoma, and urothelial carcinoma (transitional cell carcinoma) of the kidney. Metastatic renal cell carcinoma to the bladder, liver, and lung subsequently developed. Deceptive inflammatory presentations can occur in aggressive synchronous renal malignancies. Recognition of this rare disease entity could prevent delays in diagnosis and treatment.
Tsai
Tsung-Hsun
TH
Department of Surgery, Division of Urology, Tri-Service General Hospital, Taipei, Taiwan.
Tang
Shou-Hung
SH
Chuang
Feng-Pin
FP
Wu
Sheng-Tang
ST
Sun
Guang-Huan
GH
Yu
Dah-Shyong
DS
Chang
Sun-Yran
SY
Cha
Tai-Lung
TL
D000208:Acute Disease; D001707:Biopsy, Needle; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D015653:Cystectomy / Q000379:methods; D003937:Diagnosis, Differential; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D011704:Pyelonephritis / Q000175:diagnosis*; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000601:surgery