Pyelocaliceal urothelial carcinoma associated with pelvis lithiasis

OBJECTIVE Epithelial neoplasms of the upper collecting system account for less than 5 percent of all urothelial tumors and they are not histologically unlike those of the bladder. We report a case of pelviocaliceal urothelial carcinoma associated with a calculus in the renal pelvis. METHODS A 75-year-old man who presented with hematuria, fever and flank pain is described. The US and CT findings disclosed a calculus in the left renal pelvis and hydronephrosis nephrectomy was performed. RESULTS The pathological analysis revealed a pelviocaliceal urothelial carcinoma on an underlying stone and overexpression of the p53 protein. CONCLUSION Diagnostic imaging techniques may fail to detect tumors of the renal pelvis with a large underlying stone. The overexpression of the p53 protein may be involved in the malignant transformation of the urothelial cells.