A Case Report of Synchronous Squamous Cell Carcinoma of the Esophagus and Renal Pelvis

Osamu Konno, Michihiko Kogure, Yukio Endo, Tomohisa Ono, Tsuyoshi Abe, Masamitsu Ogata, Hiroshi Hojo*, Hitoshi Inoue, Ryoichi Motoki

First Department of Surgery and First Department of Pathology*, Fukushima Medical College

A 78-year-old man had a history of acute nephritis at the age of 50 years. He was diagnosed as having esophageal carcinoma with he visited a nearby physician with the main complaint of precordial discomfort, and was transferred to our hospital. On preoperative abdominal CT, a massive lesion was detected in the uppermost site of the left kidney. Therefore surgery (esophagectomy without thoracotomy and transabdominal radical nephrectomy) was performed on the basis of a diagnosis of synchronous double cancer or isolated metastasis of esophageal carcinoma to the kidney. A surgical specimen of the esophagus revealed moderately-differentiated synchronous squamous cell carcinoma (SCC) with a depth of sm, and invasion of both ly and v. In the kidney, well-differentiated SCC proliferating into the parenchyma was observed. Although we had difficulty in identifying the renal tumor as an isolated renal metastasis of esophageal carcinoma or primary carcinoma, the tumor was defined as primary SCC of the renal pelvis because severe dysplasis was observed in the transitional epithelium in the vicinity of the tumor. Since squamous epithelial cells were observed in urinary sediment obtained before the operation, it was hypothesized that the transitional epithelium had squamous metaplasia, and then progressed to carcinoma. Although a patient with renal pelvic SCC should be carefully observed after surgery because this tumor sometimes occurs bilaterally, the patient had been in good condition for 2 years after the operation without evidence of recurrence.

Key words
synchronous squamous cell carcinomas, esophageal carcinoma, renal pelvic carcinoma

Reprint requests
Osamu Konno First Department of Surgery, Fukushima Medical College
1 Hikarigaoka, Fukushima, 960-12 JAPAN

Accepted
June 17, 1992

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