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. 2024 Nov 4;8(1):56-59.
doi: 10.1002/iju5.12809. eCollection 2025 Jan.

A rare case of retroperitoneal recurrence as squamous cell carcinoma 10 years after nephroureterectomy

Koichiro Uehara  1 , Tatsuaki Onuki  1 , Yukari Ishibashi  1 , Sayuki Matsunuma  1 , Hiroaki Ishida  1 , Jiro Kumagai  2 , Takayuki Murakami  1
Affiliations

A rare case of retroperitoneal recurrence as squamous cell carcinoma 10 years after nephroureterectomy

Koichiro Uehara et al. IJU Case Rep. .

Abstract

Introduction: Local recurrence for upper tract urothelial carcinoma typically occurs within 2 years post-surgery. We report a rare case of retroperitoneal recurrence as squamous cell carcinoma 10 years after nephroureterectomy.

Case presentation: A 67-year-old female was referred to our urology department for a left ureteral tumor. The surgical specimen of the laparoscopic left nephroureterectomy revealed urothelial carcinoma at the pT3 stage. Ten years post-nephroureterectomy, magnetic resonance cholangiopancreatography revealed a mass lesion in the left retroperitoneum, a computed tomography-guided biopsy revealed squamous cell carcinoma. Despite suspected distant metastases of other organ tumors, examinations such as digestive endoscopy and bronchoscopy did not reveal any tumor lesions. The patient was diagnosed with recurrent invasive urothelial carcinoma as a pathological feature of squamous cell carcinoma.

Conclusion: The decision-making process for treating malignant tumors, such as in cases with recurrence as squamous cell carcinoma, can be challenging.

Keywords: pembrolizumab; retroperitoneal recurrence; squamous differentiation; upper tract urothelial carcinoma; urothelial carcinoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Pre‐treatment imaging. Abdominal contrast‐enhanced CT revealed a left ureteral tumor.
Fig. 2
Fig. 2
Gross and microscopic findings of the renal and ureteral tumors. (a) Lesions extending from renal pelvis to ureter. (b) UC showing papillary structures with parenchymal invasion (Elastica Van Gieson staining, ×20). (c) Stratified cellular structures with stratification centered on the stroma (H&E staining, ×100).
Fig. 3
Fig. 3
Post‐recurrence imaging. (a) MRCP showed a peritoneal lesion (diffusion weighted imaging). (b, c) PET‐CT showing FDG uptake in the peritoneal lesions.
Fig. 4
Fig. 4
Microscopic findings of the peritoneal lesion (CT guided biopsy). (a) Tumor tissue with abundant fibrous components (H&E staining, ×20). (b) SCC with keratinization (H&E staining, ×400). (c) SCC with intercellular bridges (H&E staining, ×1000). (d–f) Pathological findings are positive for cytokeratin5/6 (d), P40 (e), and P63 (f).
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