Transitional cell carcinoma of the renal pelvis

Case contributed by Dr Ian Bickle

Presentation

Male patient with PR bleeding. CT performed for staging of rectal tumour.

Patient Data

Age: 70
Gender: Male

Filling defect of higher attenuation than urine in the right renal pelvis - this was an incidental finding. Distal rectal tumour and synchronous sigmoid tumour.

CT

CT-IVU peformed for further assessment, at a later point.

After a 5 day interval and appropriate other non-imaging investigations, the patient returned for a dedicated CT-IVU.

The right renal pelvis filling defect persists - better elucidated as now a clear filling defect in the contrast filled pelvis. It appears adherent to the urothelium. 

Case Discussion

The CT was performed for staging of a endoscopically diagnosed rectal tumour. Two further tumours were identified:

  1. Synchronous sigmoid tumour
  2. Right renal pelvis TCC (this was confirmed on ureteroscopy and biopsy)

This case demonstrates the radiological error of "satisfaction of search" if the latter two pathologies were not discovered after finding the first tumour. 

Histology

  1. Rectum: Infiltrating malignant tumour composed of complex glands lined by columnar cells with pleomorphic vesicular nuclei with prominent nucleoli and abundant cytoplasm. A moderately differentiated adenocarcinoma.
  2. Renal pelvis mass: malignant tumour composed of round to elongated cells arranged in diffuse sheets. Appearances are of a transitional cell carcinoma.
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Case information

rID: 25450
Case created: 26th Oct 2013
Last edited: 4th Nov 2017
Inclusion in quiz mode: Included

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