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Background  Renal squamous cell carcinoma is a rare neoplasm with poor prognosis. Chronic irritation from nephrolithiasis and/or pyelonephritis is the leading cause.    Case presentation  We described a 51-year-old male patient who was admitted because of left flank pain. Ultrasonography showed a renal cyst containing calculus. However, contrast-enhanced ultrasonography and CT scan revealed an irregular-shaped mass derived from a calculi-containing cyst. Ultrasound guided biopsy confirmed the diagnosis of renal squamous cell carcinoma. The patient refused any further therapeutic management and died six months later.    Conclusions  Our present case emphasizes that the careful diagnostic work-up and use of multiple imaging modalities in cases of unusual renal calculi is quite necessary, since they may carry the risk of co-existing hidden malignancy.

Primary renal squamous cell carcinoma mimicking the renal cyst: a case report and review of the recent literature