Small Cell Carcinoma of the Renal Pelvis: A Case Report and Review of the Literature

Table 1

All published reports of patients with small cell carcinoma of the renal pelvis.

Pt no	Author, year	Age (Y), sex	History and investigations	Histopathology and ultrastructural findings	Treatment	Followup
(1)	Mills et al., 1988 [5]	66, M	Left flank pain and hematuria	4.7 cm tumor, SCC with TCC in situ	Left nephrectomy	DOD, 6 months
(2)	Essenfeld et al., 1990 [6]	66, F	Intermittent hematuria, tiredness; Phenacitin abuse × 10 years; IVP—left kidney not visualized; RGP—left renal mass	7×3×2 cm papillary mass in the left renal pelvis, no infiltration into the renal parenchyma; SCC with grade III TCC	Left nephrectomy	DF, 16 months; TCC in the opposite renal pelvis
(3)	Essenfeld et al., 1990 [6]	62, F	Anorexia, asthenia, right flank discomfort and recurrent cystitis × 3 weeks.; Heavy smoker, B/l nephrolithiasis × 34 years; IVP—right renal mass, multiple staghorn calculi; CECT scan-right renal mass, no metastases.	SCC with grade III papillary TCC	Right nephrectomy adjuvant CTx; vinblastin and mitomycin → poor response → cyclophosphamide and 5-flurouracil	DOD; lung metastases, 8 months
(4)	Guillou et al.,1993 [7]	71, F	Intermittent RUQ pain × 2 months; Smoker, 50 pack-years; US and CECT scan—right renal pelvis tumor, no metastases.; Needle biopsy—SCC	5 cm tumor in the renal pelvis, SCC with TCC; Scarce neurosecretory granules; Plentiful desmosomes	Right nephrectomy adjuvant CTx; 6 cycles of carboplatin + teniposide regional LN recurrence 3 months after surgery → RT, 50 Gy to renal bed and scalp metastases	DOD, 8 months
(5)	Mazzucchelli et al., 1995 [8]	37, F	Gross hematuria × weeks; Smoker 1PPD; CECT scan—15×10×8 cm right renal pelvis tumor infiltrating into the perirenal fatty tissue; retroperitoneal LN metastases	undifferentiated SCC with rare foci of grade III TCC, tumor infiltrating into the perirenal fatty tissue,; retroperitoneal LN metastases seen; neurosecretory granules seen	Right nephrectomy Adjuvant CTx; cyclophosphamide	DOD; local progression and liver metastases, 3 months
(6)	Kuromatsu et al., 1995 [9]	78, M	Gross hematuria; CECT scan and RGP—right renal pelvis tumor	SCC with Grade II TCC; scattered desmosomes seen	Right radical nephroureterectomy	DOD; peritoneal carcinomatosa, liver and LN metastases, 7 months
(7)	Kitamura et al., 1997 [10]	83, F	Right back pain with hematuria × 2 months; USG, IVP, CT scan—right kidney lower pole tumor; Urine Cytology—class V TCC.	SCC with squamous and; glandular differentiation.; venous and lymphatic invasion seen	Right nephrectomy	DOD; systemic metastases, 2 months
(8)	Kojima et al., 1998 [11]	61, F	Left lumbar pain, gross hematuria and high fever.; CECT scan—left renal pelvis tumor, infiltrating the kidney with hilar lymphadenopathy	SCC; neurosecretory granules seen	Neoadjuvant CTx; methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC); Left nephrectomy	DOD, 3 months
(9)	Chuang and Liao 2003 [12]	42, M	Hematuria	SCC with TCC	Nephroureterectomy	DOD; lung metastases, 6 months
(10)	Chuang and Liao 2003 [12]	44, F	Hematuria and pain	SCC with TCC	Nephroureterectomy	DOD; lung, bone and LN metastases 31 months
(11)	Shimasaki et al., 2005 [13]	61, F	Right flank pain, microhematuria, progressive renal dysfunction.; Urine Cytology—TCC; US and CT scan—right kidney middle pole tumor; RGP—right renal pelvis tumor extending into PUJ	6.5×4×3 cm tumor in the right renal pelvis; SCC with sarcomatoid squamous cell carcinoma; No extra renal invasion seen	Radical right nephroureterectomy with lymph node dissection	DF, 11 months
(12)	Banerji et al., 2008 [14]	55, M	Right flank pain × 6 months; CECT—1.5×1.5 cm pelvi-calyceal lesion and ureteric thickening 12 cm from the renal hilum with para-aortic and interaortocaval lymphadenopathy	1×1×2 cm tumor in the renal pelvis demonstrated only small cell carcinoma component and 7×1×1.5 cm tumor in the ureter had both transitional cell and small cell components; No lymph node metastases	Radical right nephroureterectomy with lymph node dissection; Adjuvant CTx; gemcitabin and carboplatin	NM
(13)	Current Patient	75, M	Low back pain × 2 weeks; MR imaging— 4.8×4×3.7 cm homogeneous mass in the left renal pelvis with mild contrast enhancement and preaortic, par-aortic, aortocaval and retrocaval lymphadenopathy	Multifocal SCC with tumor emboli in the renal artery and lymphatics, tumor extended beyond fascia Gerota; 4/4 LN positive for metastases	Radical right nephroureterectomy	Died of pneumonia 2 months after surgery

Y: years, F: female, M: male, IVP: intravenous pyelography, RGP: retrograde pyelography, SCC: small cell carcinoma, TCC: transitional cell carcinoma, DF: disease free, LN: lymph node, CTx: chemotherapy, US: ultrasound, Gy: gray, PPD: pack per day, PUJ: pelvis-ureter junction, NM: not mentioned, and MR: magnetic resonance imaging.