title: Endoscopic management of keratinizing desquamative squamous metaplasia of the upper tract: a case report and review of the literature.
abstract: Keratinizing desquamative squamous metaplasia (KDSM), also known as leukoplakia or cholesteatoma, of the genitourinary tract is a rare condition that is difficult to differentiate from a malignant process without surgical intervention. We present a case of KDSM of the upper urinary tract that was managed via percutaneous endoscopic approach. Although KDSM is a benign lesion, there are rare reports of it occurring concurrently with squamous-cell carcinoma; however, no direct causal relationship has been identified. This case demonstrates the ease with which KDSM can be removed by peeling it away from the underlying parenchyma; however, surgical intervention may not be necessary in the asymptomatic patient after evaluation has ruled out malignancy. Regardless of how KDSM is managed, follow-up is important because these lesions are known to recur.
authors.affiliation: Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Anjana
authors.initials: A
authors.lastname: Ganeshappa
authors.forename: Amy
authors.initials: A
authors.lastname: Krambeck
authors.forename: David J
authors.initials: DJ
authors.lastname: Grignon
authors.forename: James E
authors.initials: JE
authors.lastname: Lingeman
mesh_terms: D000368:Aged; D002781:Cholesteatoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007670:Kidney Calices / Q000000981:diagnostic imaging / Q000473:pathology; D008679:Metaplasia; D014057:Tomography, X-Ray Computed; D014551:Urinary Tract / Q000473:pathology* / Q000601:surgery*