Jung Jinho, Shu Chang, Hassani Parvaneh, Phillipi Michael, Lee Vincent, Houshyar Roozbeh, Shi James
School of Medicine, University of California, Irvine, CA, USA.
University of California, Computational Abdominal Radiology Lab, Orange, CA, USA.
Radiol Case Rep. 2025 Apr 26;20(7):3403-3408. doi: 10.1016/j.radcr.2025.04.029. eCollection 2025 Jul.
Urothelial carcinoma is the primary malignancy of the urothelium that has varying radiographic features based on the location of the tumor. Differentiating urothelial carcinoma from renal cell carcinoma is critical as interventions and management methods differ. We present a case of urothelial carcinoma within the calyceal diverticula that was initially suspected to represent Bosniak IV cyst due to cystic renal cell carcinoma. A 71-year-old male with a history of gross hematuria and a previously identified Bosniak II renal cyst underwent further imaging, revealing a Bosniak IV cystic mass with enhancing nodules. Subsequent nephrectomy unveiled noninvasive low-grade papillary urothelial carcinoma within a calyceal diverticulum. This case highlights the complexity of diagnosing urothelial carcinoma within the calyceal diverticula, emphasizing the need for a high index of suspicion. The study contributes to understanding the limitations of imaging modalities, especially in cases involving calcification or stone evaluation. The coexistence of urothelial carcinoma and calyceal diverticula is rare but crucial for accurate diagnosis and treatment. Documenting cases like these is vital for recognizing urothelial carcinoma mimics and ensuring appropriate patient management. The study underscores the significance of distinguishing features of calyceal diverticula and advocates for comprehensive imaging approaches in renal cystic lesions.
尿路上皮癌是尿路上皮的原发性恶性肿瘤，根据肿瘤位置具有不同的影像学特征。由于干预措施和管理方法不同，鉴别尿路上皮癌与肾细胞癌至关重要。我们报告一例肾盂憩室内尿路上皮癌病例，该病例最初因囊性肾细胞癌而被怀疑为博斯尼亚克IV级囊肿。一名有肉眼血尿病史且先前已确诊为博斯尼亚克II级肾囊肿的71岁男性接受了进一步影像学检查，发现一个有强化结节的博斯尼亚克IV级囊性肿块。随后的肾切除术显示肾盂憩室内为非侵袭性低级别乳头状尿路上皮癌。该病例突出了诊断肾盂憩室内尿路上皮癌的复杂性，强调了高度怀疑的必要性。该研究有助于理解影像学检查方法的局限性，尤其是在涉及钙化或结石评估的病例中。尿路上皮癌与肾盂憩室并存罕见，但对于准确诊断和治疗至关重要。记录此类病例对于识别尿路上皮癌的模仿病变并确保患者得到适当管理至关重要。该研究强调了肾盂憩室鉴别特征的重要性，并提倡对肾囊性病变采用综合影像学检查方法。
