Case Report
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2014; 2(6): 215-218
Published online Jun 16, 2014. doi: 10.12998/wjcc.v2.i6.215
Pyonephrosis as a sign of sarcomatoid carcinoma of the renal pelvis
Sergio Fernández-Pello, Victoria Venta, Iván González, Rodrigo Gil, Carmen Luz Menéndez
Sergio Fernández-Pello, Iván González, Rodrigo Gil, Department of Urology, Cabueñes Hospital, 33394 Gijón, Spain
Victoria Venta, Carmen Luz Menéndez, Department of Pathology, Cabueñes Hospital, 33394 Gijón, Spain
Author contributions: All the authors equally contributed to this paper.
Correspondence to: Sergio Fernández-Pello, MD, Department of Urology, Cabueñes Hospital, Calle de los prados 395, 33394 Gijón, Spain. spello84@hotmail.com
Telephone: +43-512-50423401 Fax: +43-512-50424052
Received: December 13, 2013
Revised: January 6, 2014
Accepted: May 8, 2014
Published online: June 16, 2014
Processing time: 189 Days and 13.6 Hours
Abstract

We report the case of an urgent nephrectomy because of a pyonephrosis and sepsis due to an unsuspected sarcomatoid transitional cell carcinoma, an infrequent subtype with a bad oncological prognosis. We present a 58-year-old man assessed by internal medicine for a general syndrome and weakness many months previously. A pyonephrotic kidney was observed at abdominal computed tomography in the context of septic shock, without suspecting the underlying cause. The pathology report described a sarcomatoid transitional cell carcinoma. Sarcomatoid transitional cell carcinoma is an invasive and infrequent subtype of urothelial tumors. The symptoms are often the same as other renal masses; however, in this case, sepsis and pyonephrosis were the rare initial symptoms.

Keywords: Urothelial carcinoma; Renal pelvis; Sarcomatoid

Core tip: Sarcomatoid transitional cell carcinoma is an invasive and rare subtype of urothelial tumors. The symptoms are often the same as other renal masses; however, in this case, sepsis and pyonephrosis were the rare initial symptoms.