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Case Reports
. 2020 Dec 3;12(12):e11871.
doi: 10.7759/cureus.11871.

A Very Rare Case of Primary Renal Squamous Cell Carcinoma Presenting With Xanthogranulomatous Pyelonephritis on Radiological Imaging

Bala C Veerabathini  1 , Kaushik Manthani  2 , Sandeep Gandhi  1 , Nerin Duddala  3
Affiliations
Case Reports

A Very Rare Case of Primary Renal Squamous Cell Carcinoma Presenting With Xanthogranulomatous Pyelonephritis on Radiological Imaging

Bala C Veerabathini et al. Cureus. .

Abstract

Xanthogranulomatous pyelonephritis (XGP) and primary renal squamous cell carcinoma (SCC) are both rare conditions that can present very similarly in a patient with renal staghorn calculi. We report a case of a 54-year-old male who presented with fatigue, vomiting and significant acute weight loss. The patient was initially believed to have XGP, but was ultimately diagnosed with both XGP and primary renal SCC. This case report and literature review is meant to elucidate the similarities and differences between XGP and primary renal SCC as both can be diagnostically challenging.

Keywords: bear paw sign; kidney; nephrectomy; proteus; pyelonephritis; renal; squamous cell carcinoma (scc); staghorn calculi; urinary tract infection; xanthogranulomatous.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Right kidney visualized with staghorn calculi and dilated renal calyces on CT of abdomen, coronal plane
Staghorn calculus is indicated by the blue arrow. Dilated renal calyces are indicated by the red arrows.
Figure 2
Figure 2. Pyelogastric fistula visualized connecting upper renal calculi with gastric antrum on CT of abdomen, coronal plane
Fistula is indicated by the blue arrow. Locules of air are indicated by the red arrows.
Figure 3
Figure 3. Subscapular hepatic hypodensities and inferior lateral renal densities visualized on CT of abdomen, coronal plane
Subscapular hepatic hypodensities are indicated by the blue arrows. Inferior lateral renal nodular densities are indicated by the red arrows along the renal fascia.
Figure 4
Figure 4. Filling defect of right renal vein/artery and posterior lateral nodular density of right kidney visualized on CT of abdomen, transverse plane
Filling defect of right renal vein/artery is indicated by the red arrow. Posterior lateral renal nodular density is indicated by the blue arrow. The air-fluid level of the stomach is indicated by the yellow arrow.
Figure 5
Figure 5. Pleural lung effusions visualized on CT of thorax, transverse plane
Pleural effusions are indicated by the blue arrows, as can be seen along the inferior border of the lungs.
See this image and copyright information in PMC

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