Transitional cell carcinoma of the renal pelvis invading the renal parenchyma in a hemodialysis patient: a case report

This report concerns a case of renal pelvic tumor preoperatively mimicking renal cell carcinoma in a hemodialysis (H) patient. The patient was a 77-year-old female who had been receiving HD for 3 years and 9 months. The patient was admitted to our hospital with complaint of symtomtic macroscopic hematuria. CT during right renal arteriography showed a strongly enhanced right renal mass measuring 3×2cm. Angiography of the right renal artery showed hypervascularity of the tumor, and urine cytology was negative. These findings strongly suggested right renal cell carcinoma. Therefore, right nephrectomy was performed. Histopathological diagnosis was a transitional cell carcinoma of the right renal pelvis invading the renal parenchyma. We discuss here the difficulties with preoperative diagnosis of urothelial cancer in hemodialysis patients because renal impairment would limit the use of contrast medium. When dialysis patients present with hemturia, a series of examinations should be performed for detection of urothelial cancer.