Giant Pyelocaliceal Transitional Cell Carcinoma Associated with Neglected Pelvic Lithiasis: Case Presentation and Review of the Literature.

Abstract

Introduction: Urinary lithiasis is one of the most common diseases in Western countries. Although there is evidence that kidney stones may be related to upper urinary tract tumors, the mechanisms that link the origin of urinary stones to the development of these tumors remain largely unclear. In this article, we present a rare case of a giant tumor of the renal pelvis associated with chronic lithiasis and discuss the association between these two conditions.

Case presentation: A 69-year-old woman was admitted to the hospital because of a high fever, pain in the left flank, and gross haematuria. She had a history of recurrent renal infection and untreated kidney stones, diagnosed 30 years ago. Imaging studies showed staghorn calculi in both kidneys and two large cystic formations within the pelvis of the left kidney. The patient underwent salvage nephrectomy. Histologic examination diagnosed high-grade urothelial carcinoma and chronic inflammation. A systematic search was performed in electronic libraries (PubMed) using the terms "transitional cell carcinoma", "renal cancer", and "urothelial carcinoma", along with "staghorn calculi", "nephrolithiasis", "urinary tract infection", and "chronic inflammation". There was no restriction on publication date.

Conclusion: According to the literature, untreated nephrolithiasis can cause both anatomical and functional damage, leading to an increased risk of developing urothelial carcinoma in the renal pelvis. Clinicians should consider the risk of developing urothelial carcinoma in patients with chronic nephrolithiasis, large stones, frequent urinary tract infections, and abnormalities observed during radiological investigations.