Table 1.
All published reports of patients with small cell carcinoma of the renal pelvis.
| Pt no | Author, year | Age (Y), sex | History and investigations | Histopathology and ultrastructural findings | Treatment | Followup |
|---|---|---|---|---|---|---|
| (1) | Mills et al., 1988 [5] | 66, M | Left flank pain and hematuria | 4.7 cm tumor, SCC with TCC in situ | Left nephrectomy | DOD, 6 months |
| (2) | Essenfeld et al., 1990 [6] | 66, F | Intermittent hematuria, tiredness Phenacitin abuse × 10 years IVP—left kidney not visualized RGP—left renal mass |
7 × 3 × 2 cm papillary mass in the left renal pelvis, no infiltration into the renal parenchyma SCC with grade III TCC |
Left nephrectomy | DF, 16 months TCC in the opposite renal pelvis |
| (3) | Essenfeld et al., 1990 [6] | 62, F | Anorexia, asthenia, right flank discomfort and recurrent cystitis × 3 weeks. Heavy smoker, B/l nephrolithiasis × 34 years IVP—right renal mass, multiple staghorn calculi CECT scan-right renal mass, no metastases. |
SCC with grade III papillary TCC | Right nephrectomy adjuvant CTx; vinblastin and mitomycin → poor response → cyclophosphamide and 5-flurouracil | DOD; lung metastases, 8 months |
| (4) | Guillou et al.,1993 [7] | 71, F | Intermittent RUQ pain × 2 months Smoker, 50 pack-years US and CECT scan—right renal pelvis tumor, no metastases. Needle biopsy—SCC |
5 cm tumor in the renal pelvis, SCC with TCC Scarce neurosecretory granules Plentiful desmosomes |
Right nephrectomy adjuvant CTx; 6 cycles of carboplatin + teniposide regional LN recurrence 3 months after surgery → RT, 50 Gy to renal bed and scalp metastases | DOD, 8 months |
| (5) | Mazzucchelli et al., 1995 [8] | 37, F | Gross hematuria × weeks Smoker 1PPD CECT scan—15 × 10 × 8 cm right renal pelvis tumor infiltrating into the perirenal fatty tissue retroperitoneal LN metastases |
undifferentiated SCC with rare foci of grade III TCC, tumor infiltrating into the perirenal fatty tissue, retroperitoneal LN metastases seen neurosecretory granules seen |
Right nephrectomy Adjuvant CTx; cyclophosphamide | DOD; local progression and liver metastases, 3 months |
| (6) | Kuromatsu et al., 1995 [9] | 78, M | Gross hematuria CECT scan and RGP—right renal pelvis tumor |
SCC with Grade II TCC scattered desmosomes seen |
Right radical nephroureterectomy | DOD; peritoneal carcinomatosa, liver and LN metastases, 7 months |
| (7) | Kitamura et al., 1997 [10] | 83, F | Right back pain with hematuria × 2 months USG, IVP, CT scan—right kidney lower pole tumor Urine Cytology—class V TCC. |
SCC with squamous and glandular differentiation. venous and lymphatic invasion seen |
Right nephrectomy | DOD; systemic metastases, 2 months |
| (8) | Kojima et al., 1998 [11] | 61, F | Left lumbar pain, gross hematuria and high fever. CECT scan—left renal pelvis tumor, infiltrating the kidney with hilar lymphadenopathy |
SCC neurosecretory granules seen |
Neoadjuvant CTx; methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) Left nephrectomy |
DOD, 3 months |
| (9) | Chuang and Liao 2003 [12] | 42, M | Hematuria | SCC with TCC | Nephroureterectomy | DOD; lung metastases, 6 months |
| (10) | Chuang and Liao 2003 [12] | 44, F | Hematuria and pain | SCC with TCC | Nephroureterectomy | DOD; lung, bone and LN metastases 31 months |
| (11) | Shimasaki et al., 2005 [13] | 61, F | Right flank pain, microhematuria, progressive renal dysfunction. Urine Cytology—TCC US and CT scan—right kidney middle pole tumor RGP—right renal pelvis tumor extending into PUJ |
6.5 × 4 × 3 cm tumor in the right renal pelvis SCC with sarcomatoid squamous cell carcinoma No extra renal invasion seen |
Radical right nephroureterectomy with lymph node dissection | DF, 11 months |
| (12) | Banerji et al., 2008 [14] | 55, M | Right flank pain × 6 months CECT—1.5 × 1.5 cm pelvi-calyceal lesion and ureteric thickening 12 cm from the renal hilum with para-aortic and interaortocaval lymphadenopathy |
1 × 1 × 2 cm tumor in the renal pelvis demonstrated only small cell carcinoma component and 7 × 1 × 1.5 cm tumor in the ureter had both transitional cell and small cell components No lymph node metastases |
Radical right nephroureterectomy with lymph node dissection Adjuvant CTx; gemcitabin and carboplatin |
NM |
| (13) | Current Patient | 75, M | Low back pain × 2 weeks MR imaging— 4.8 × 4 × 3.7 cm homogeneous mass in the left renal pelvis with mild contrast enhancement and preaortic, par-aortic, aortocaval and retrocaval lymphadenopathy |
Multifocal SCC with tumor emboli in the renal artery and lymphatics, tumor extended beyond fascia Gerota 4/4 LN positive for metastases |
Radical right nephroureterectomy | Died of pneumonia 2 months after surgery |
Y: years, F: female, M: male, IVP: intravenous pyelography, RGP: retrograde pyelography, SCC: small cell carcinoma, TCC: transitional cell carcinoma, DF: disease free, LN: lymph node, CTx: chemotherapy, US: ultrasound, Gy: gray, PPD: pack per day, PUJ: pelvis-ureter junction, NM: not mentioned, and MR: magnetic resonance imaging.