Primary Renal Squamous Cell Carcinoma A Report Of 4 Cases And Literature Review

Objective To summarize and understand the clinical manifestations of primary renal squamous cell carcinoma,to analyze the causes of missed diagnosis and misdiagnosis,and improve the diagnosis and treatment of this disease.Methods The clinical data of 4 cases of primary renal squamous cell carcinoma in our hospital were analyzed retrospectively.Then,the risk factors,clinical manifestations,diagnosis and treatment of primary renal squamous cell carcinoma were analyzed in combination with the literature.Results Case 1 was diagnosed preoperatively as follows: 1.Left kidney space occupying;2.Bilateral renal calculi.It was treated by left radical nephrectomy and the postoperative pathology results indicated that the left kidney was a kind of poorly differentiated squamous cell carcinoma,which broke through the perirenal fascia to invade the psoas major muscle and peritoneum.Case 2 was diagnosed preoperatively as follows: 1.Malignant tumor of left kidney;2.Left renal calculi;3.Hydronephrosis and pyonephrosis of left kidney.It was treated by left radical nephrectomy and the postoperative pathology results indicated that the left kidney was a kind of medium-high differentiation squamous cell carcinoma,which infringed the left paranephrosand upper ureter.Case 3 was diagnosed before operation as follows: 1.Right ureteral cancer;2.Right hydronephrosis.It was treated by right radical nephrectomy and the postoperative pathology results indicated that the right kidney and renal pelvis were a kind of high differentiation squamous cell carcinoma and the right kidney was full of yellow pus.Case 4 was diagnosed before operation as follows: 1.Left renal calculi complicated with infection;2.Left kidney space occupying;3.Left perinephric infection.It was treated by left radical nephrectomy and the postoperative pathology results indicated that the left kidney was a kind of high differentiated squamous cell carcinoma.All the 4cases did not receive radiotherapy or chemotherapy after operation.And they died of metastasis 8 months,9 months,1 year and 11 months after surgery.Conclusion Primary renal squamous cell carcinoma is rare in clinic.The pathopoiesis of this disease is occult,and has no characteristic clinical manifestations and imaging features.It is often covered by kidney stones,hydronephrosis or pyonephrosis,chronic nephritis and other diseases.Besides,some cases can not be examined by biopsy because of the limitation of tumor location.Therefor,it is easy to miss diagnosis and misdiagnosis in clinic.Urinary CT is preferred for preoperative examination,and radical nephrectomy is preferred for treatment.