Poster Farina Fix

Primary Squamous Cell Carcinoma of the Kidney:
A very rare case

Farina Dwinanda Faisal, Sahyuddin Saleh, Azwar Amir, Tutik Harjianti, Andi Fachruddin,
Rahmawati Minhajat, Dimas Bayu
Division of Hematology and Medical oncology, Department of Internal Medicine,
Faculty of Medicine, University of Hasanuddin Makassar, South Sulawesi, Indonesia
INTRODUCTION
Case review
Squamous cell carcinoma (SCC) of the renal parenchyma is a very rare

entity that tends to be associated with nephrolithiasis, chronic infection and
inflammation. Until March 2023, there were only 10 cases reported in the
world. Diagnosis of renal SCC tends to be difficult and often late. Patients
diagnosed at an advanced stage because of signs, clinical symptoms and
radiological findings are not specific. Due to their rarity, these cases were
often unsuspected before surgery. Up to now, there has been no standard
therapy for renal SCC. We report a case of a 65-year-old man with primary
SCC of renal parenchyma with a history of recurrent nephrolithiasis
CASE ILLUSTRATION
A 65-year-old man was referred to our hospital with left-sided abdominal pain
and history of kidney stones. On physical examination, a palpable mass was
found on the left side of the abdomen
CT scan, a heterogeneous, predominantly cystic mass with clear boundaries and

Discussion
septations with a size of +/- 14.41 x 16.10 x 22.43 cm3 was seen, accompanied by
Fig 1.CT Abdomen Result stones in the left kidney, multiple right nephroliths, multiple lymphadenopathy and
prostate hypertrophy.
Patient then underwent radical nephrectomy. Histopathology examination reveals
a Well differentiated Keratinizing Squamous Cell Carcinoma with interstitial
nephritis.
Two months after the nephrectomy, the patient's functional status tended to
Fig 2. Histopathology Result
decrease (ECOG 4), the patient suffered right sided weakness and Brain CT scan
reveals multiple bilateral hypodense cerebral lesions suggestive of metastases
and bone metastases.
The patient was then diagnosed with stage IV renal SCC (T3aN1M1). After 2 weeks
of palliative treatment, the patient's condition worsened until the patient died
Fig 3. Histopathology Result
DISCUSSION
Primary SCC of renal parenchyma is a very rare condition, accounting for 0.5%–0.8% of renal malignancies, mostly in the fifth and seventh
decades of age. Urinary tract stones, especially kidney stones, hydronephrosis and chronic infection are associated with an etiology
which then lead to metaplasia and dysplasia in kidney cells resulting in SCC of the kidney. Up to now, there are no standard guidelines
and protocols for treating renal SCC. Nephrectomy is still chosen as the main treatment. Adjuvant or neoadjuvant platinum-based
chemotherapy may be considered, but these treatments are not showing improvement in survival. Five years overall survival for patients
with SCC in the upper urinary tract is less than 10%, much worse than patients with urothelial carcinoma.
SUMMARY
We reported one very rare case of Primary SCC of renal parenchyma who underwent radical nephrectomy. Distant metastases to the
brain and bones were found 2 months post nephrectomy. The patient was worsening rapidly and only received palliative care until died.
REFERENCES
1. Liang K, Yuan Y, Lv B, Ke Z. Primary squamous cell carcinoma of renal parenchyma: A case report and literature review [Internet]. Vol. 13, Frontiers in Oncology . 2023. Available from: https://www.frontiersin.org/articles/10.3389/fonc.2023.1037156
2.Attalla K, Haines K, Labow D, Mehrazin R. Squamous Cell Carcinoma of the Renal Pelvis: Atypical Presentation of a Rare Malignancy. Urol Case Rep. 2017 May 19;13:137-139. doi: 10.1016/j.eucr.2017.04.007. PMID: 28567328; PMCID: PMC5440740.
3.Brits, N.F., Bulane, S. & Wadee, R. Primary squamous cell carcinoma of the kidney: a case report and review of the literature. Afr J Urol 26, 79 (2020). https://doi.org/10.1186/s12301-020-00088-9
4.Hsu, C., Lee, H., Shen, J., Tsai, K., Huang, C.. Squamous cell carcinoma of the renal pelvis—a rare case report. Therapeutic Radiology and Oncology, North America, 2, jun. 2018. Available at: <https://tro.amegroups.com/article/view/4322>
5.Varshney B, Nalwa A, Yadav T, Choudhary G. Renal Squamous Cell Carcinoma Presenting With Renohepatic Fistula: A Rare Amalgam. Ochsner J. Published online 2022. doi:10.31486/toj.22.00395. Vagholkar K. Obstructive Jaundice: Understanding the
pathophysiology. Int J Surg Med. 2020;6(0):1. doi:10.5455/ijsm.2020-07-061-jaundice

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Primary Squamous Cell Carcinoma of the Kidney:

A very rare case

Squamous cell carcinoma (SCC) of the renal parenchyma is a very rare

CT scan, a heterogeneous, predominantly cystic mass with clear boundaries and

Fig 3. Histopathology Result

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