Maryam Abolhasani
1,2 
, Nikoo Emtiazi
3* , Soroush Shahrokh
4, Koosha Kamali
51 Oncopathology Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2 Pathology Department, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
3 Department of Pathology Medicine, Rasool Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
4 Department of Internal Medicine, University of Houston College of Medicine/HCA Houston Healthcare Kingwood, Houston, Texas
5 Urology Department, Hasheminejad Kidney Center (HKC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Abstract
Primary adenocarcinoma of the renal pelvis, particularly when accompanied by precancerous lesions in other organs of the urinary tract such as the bladder or ureter, is a rare finding. This type of malignancy is usually associated with inflammation, long-term urinary obstruction, and renal calculi. In this report, we present a new case of intestinal-type adenocarcinoma of the renal pelvis with precancerous bladder lesions. Initially, the diagnosis was polypoid cystitis based on a small bladder biopsy. However, subsequent transurethral resection of the bladder one month later revealed intestinal-type cystitis glandularis with mucin extravasation. The exacerbation of clinical symptoms led to right nephroureterectomy two years later, which revealed adenocarcinoma of the renal pelvis. The patient underwent chemotherapy and is now disease-free six months later. The most significant challenge in managing adenocarcinoma of the renal pelvis is ruling out distant metastasis or direct invasion of the tumor from adjacent organs, as well as the possibility of multifocality in other foci of the urinary tract.