Renal Pelvis Squamous Cell Carcinoma and Renal Cell Carcinoma in a Tuberculous Kidney

A 70-year-old male presented to the emergency room with left flank pain and fever. He was treated for renal tuberculosis 30 years prior to his presentation. Physical exam revealed left costoverteberal angle tenderness, while laboratory exam demonstrated leukocytosis and pyuria. Serum renal function tests were normal. He was initially treated as an acute pyelonephritis with intravenous antibiotics. A CT scan of the abdomen and pelvis showed an enhancing mass at the lower pole of the left kidney; further work-up shows no evidence of metastasis. He subsequently underwent a left radical nephrectomy with an uneventful postoperative course. Pathological findings were consistent with old renal tuberculosis (Fig. 1), SCC of renal pelvis (Fig. 2), and RCC (Fig. 3). Patient has no evidence of metastasis after 3 years follow-up.