Publication:

A rare case of squamous cell carcinoma with xanthogranulomatous pyelonephritis in a patient with chronic obstructive renal calculi

Squamous cell carcinoma (SCC) of the kidney is a rare entity. Often it is confused with Xanthogranulomatous Pyelonephritis (XGP), which is a chronic inflammatory disorder of the kidney, associated with the destruction of the renal parenchyma usually in the setting of an infectious process.  A 76 year old male presented with right flank pain and vomiting. On examination, was found to have tenderness with localized guarding in the right flank. Investigations revealed a mass arising from the lower pole of the right kidney which was hydronephrotic and had features suggestive of stage III xanthogranulomatous pyelonephritis (XGP) with pyonephrosis and the presence of multiple calculi. Patient initially underwent a drainage of the pyonephrosis and subsequent nephrectomy.  Histopathology revealed the presence of both XGP and SCC in the resected kidney specimen. Chronic nephrolithiasis is a predisposing factor for both XGP and SCC. XGP shares many characteristics with SCC in terms of both its radiographic appearance and its ability to involve the adjacent structures. Chronic nephrolithiasis is a predisposing factor for both XGP and SCC. XGP shares many characteristics with SCC in terms of both its radiographic appearance and its ability to involve the adjacent structures.