PMC7277044_01
(a) A complete staghorn calculus of the left kidney (about 8 cm). (b) After the 1st ECIRS, a renal stone in the pelvis was removed. (c) After the 2nd ECIRS, most of the renal stone was removed. (d) After the last ECIRS, a stone-free state was achieved.
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The doctor carried out an X-ray of the kidney, ureter, and bladder and made a diagnosis of a staghorn calculus in the left kidney (Figure 1(a)). Part of the left renal stone still existed, especially in the inferior calyx of the kidney (Figure 1(b)). ECIRS was performed one month later, and we were able to insert the trocar at this time and carry out the procedure as planned (Figure 1(c)). ECIRS was performed and allowed the majority of the kidney stone to be removed (Figure 1(d)).
A complete staghorn calculus of the left kidney. The major diameter was about 8 cm. We could not identify the renal pelvic carcinoma retrospectively.
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We performed no contrast-enhanced CT of the abdominal and pelvis, which revealed an 8 cm renal stone in the left renal pelvis (Figure 2).
The renal tumor invaded the renal parenchymal and expanded about 10 cm. Lymph nodes can be seen expanded around the renal artery (red arrows). The clinical stage was classified as T4N1M0.
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The tumor had expanded to around the left renal artery although there was no metastatic lesion (Figure 3).
Urothelial carcinoma with squamous differentiation. Stratified squamous epithelium and keratinization of the lesion can be seen in some areas.
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Histological examination revealed an invasive urothelial carcinoma with squamous differentiation and a clinical stage of T4N0M0 (Figure 4).