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CASE REPORT |
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| Year : 2004 | Volume
: 20
| Issue : 2 | Page : 172-174 |
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Mucinous cystadenocarcinoma of renal pelvis - a case report
Vinay A Chougule, KR Babli, Mukund G Andankar, Sandhya R Rao, Hemant R Pathak
Department of Urology, TN.Medical College and B.Y.L. Nair Hospital, Mumbai, India
Correspondence Address:
Hemant R Pathak
Department of Urology, TN Medical College and BYL Nair Hospital, Mumbai Central, Mumbai - 400 008
India
 Source of Support: None, Conflict of Interest: None  | Check |
Keywords: Cystadenocarcinoma, renal pelvis
How to cite this article:
Chougule VA, Babli K R, Andankar MG, Rao SR, Pathak HR. Mucinous cystadenocarcinoma of renal pelvis - a case report. Indian J Urol 2004;20:172-4 |
 Case Report | |  |
A 35-year-old female presented with history of continuous, dull ache on the right side of abdomen for 2 years. She also noticed a slowly increasing mass on the right side 4 months back. She had undergone right-sided pyelolithotomy twice, 5 years and 2 years earlier.
On examination a firm, bimanually palpable lump, extending from the right hypochondrium to the right iliac fossa was noticed. No other significant finding was noted. X-ray KUB region showed a 1 cm radio-opaque density in the right renal region. On ultrasonography a cystic, septate mass, 12 x 20 cm in size extending from the liver to the iliac fossa was seen with no obvious renal tissue. Contrast enhanced computerized tomography of the abdomen and pelvis confirmed a non-enhancing 12 x 15 x 20 cm cystic mass, extending from the liver to the right iliac fossa eroding the iliac crest.
The retroperitoneal mass was explored through a 11 th rib bed incision. It was cystic, adherent on all sides and it ruptured during mobilization with a gush of almost 1 1 of gelatinous material coming out. The mass was removed completely. Gross examination revealed a kidney with a dilated, thin walled pelvicalyceal system and cystic spaces filled with mucinous material [Figure - 1]. Histopathological examination revealed a mucin secreting glandular epithelium with large hyperchromatic nuclei without fibrotic reaction suggestive of mucinous cystadenocarcinoma of the renal pelvis [Figure - 2].
| Comments | | |
Mutinous cystadenocarcinoma of the renal pelvis is a very rare condition with only 95 cases reported so far. [1]
Mucinous cystadenocarcinoma of the renal pelvis is a very rare tumour comprising less than 0.3% of total renal pelvic tumours. [2] The etiology is thought to be due to the unique ability of transitional epithelium to respond with a glandular metaplastic change due to chronic infection or irritation; this metaplasia may occasionally initiate glandular tumours. Terris et al reported a case of mucinous adenocarcinoma of the renal pelvis and ureter presenting as chronic flank pain, calculus and hydronephrosis in an immigrant from India. They report a literature review suggesting a high frequency of this otherwise rare tumour in India with an inflammatory, environmental or dietary etiology. [3]
Usual features of this tumour include long duration of symptoms, association with calculi and hydronephrosis and a preoperative appearance of an inflammatory condition. The occurrence of this tumour, though rare, should be kept in mind especially if a renal mass lesion is associated with recurrent calculus disease. [2]
This tumour is classically treated by radical excision with postoperative chemotherapy. However, it has a very poor prognosis.
| References | | |
| 1. | Ueda T, Okumi M, Fujimoto N. Mucinous adenocarcinoma of renal pelvis in the horseshoe kidney. Hinyokika kiyo 2002; 48(3): 187-9 (Article in Japanese).  |
| 2. | Kakkar N, Joshi K, Mandal AK. Mucinous adenocarcinoma of the renal pelvis. Ind J Pathol Micro 1997; 40: 393-5. |
| 3. | Terris MK, Anderson RU. Mucinous adenocarcinoma of renal pelvis in natives of India. Urol Int 1997; 58(2): 121-3. |
[Figure - 1], [Figure - 2]
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