PMC8112967_01
Ultrasonography findings. a: An 8-cm mass lesion (dotted arrow) in the lower portion of the right kidney. Color Doppler signal indicates vascularity within the mass (black arrows). b: Magnetic resonance imaging (MRI) showed hypointensity on T2-weighted imaging (black arrows). c: Computed tomography (CT) after the administration of contrast media showed that the tumor margin and parenchyma were enhanced compared with multiple renal cysts (black arrows). A renal stone 30 cm in size was seen in the center of the mass (dotted arrow).
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Ultrasonography showed vascularity with color-Doppler (Fig. 1a), MRI showed hypointensity on T2-weighted imaging (Fig. 1b), and CT showed enhancement after the administration of contrast media (Fig. 1c).
Histology of the surgical specimen. a: A solid mass (arrow) measuring 90x80x90 mm and a renal stone measuring 40x30x20 mm in size were observed in the lower pole of the kidney. b: Microscopy shows well-differentiated squamous cell carcinoma [Hematoxylin and Eosin (H&E) staining x40]. c: Magnification of figure 2b (*) shows cancer nests of squamous cell carcinoma (H&E staining x120). d: Magnification of figure 2b (**) shows squamous metaplasia of renal pelvis mucosa (arrow) (H&E staining x120). e: Clinical course. The patient started to feel general malaise one month before admission. The operation was performed after one and a half months. The CK level gradually decreased after the operation and was within the normal range when she died from intractable hepatic cyst infection.
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A yellowish-white to white solid mass measuring 90x80x90 mm was observed in the lower pole of the kidney (Fig. 2a). This diagnosis was confirmed by cancer nests of squamous epithelial cell pearls with eosinophilic cytoplasm, indicating keratinization (Fig. 2b, c). These cancer nests appeared to be developing further into squamous metaplasia of the renal pelvis mucosa (Fig. 2b, d). She ultimately died two months after surgery because of intractable hepatic cystic infection(Fig. 2e).