Skip to main content

Tumors of the Renal Pelvis

  • Chapter
  • First Online:
Kidney Cancer

Abstract

Tumors of the renal pelvis are relatively uncommon and account for 5–8% of all renal tumors. Renal pelvic tumors are generally grouped with ureteral tumors together as tumors of the upper urinary tract (UUT). The vast majority of UUT tumors are composed of urothelial carcinoma (UC). UUTUCs are classified as two major groups, noninvasive and invasive UC, using a classification system similar to that for bladder UC. The noninvasive group is divided into papillary neoplasms and flat lesions, which are further classified into several distinct categories. The invasive group includes conventional UC as well as a number of histologic variants. The pathologic and clinical features of these renal pelvic tumors are discussed in this chapter.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7–30.

    Article  PubMed  Google Scholar 

  2. Flanigan RC. Urothelial tumors of the upper urinary tract. In: Wein AJ, Kavoussi LR, Novick AC, et al., editors. Campbell-Walsh urology. 9th ed. Philadelphia: Elsevier; 2007. p. 1638–52.

    Google Scholar 

  3. Melamed MR, Reuter VE. Pathology and staging of urothelial tumors of the kidney and ureter. Urol Clin North Am. 1993;20:333–47.

    CAS  PubMed  Google Scholar 

  4. Comperat E, Al-ahmadie H. Epithelial tumours of the upper urinary tract. In: Moch H, Humphrey PA, Ulbright TM, et al., editors. World Health Organization Classification of tumours of the urinary system and male genital organs. 4th ed. Lyon: IARC Press; 2016. p. 131.

    Google Scholar 

  5. Murphy WM, Grignon DJ, Perlman EJ, editors. AFIP atlas of tumor pathology: tumors of the kidney, bladder, and related urinary structures. 4th ed. Washington D.C.: American Registry of Pathology; 2004. p. 375–82.

    Google Scholar 

  6. Olgac S, Mazumdar M, Dalbagni G, et al. Urothelial carcinoma of the renal pelvis: a clinicopathologic study of 130 cases. Am J Surg Pathol. 2004;28:1545–52.

    Article  PubMed  Google Scholar 

  7. Gupta R, Paner GP, Amin MB. Neoplasms of the upper urinary tract: a review with focus on urothelial carcinoma of the pelvicalyceal system and aspects related to its diagnosis and reporting. Adv Anat Pathol. 2008;15:127–39.

    Article  PubMed  Google Scholar 

  8. Favaretto RL, Shariat SF, Chade DC, et al. The effect of tumor location on prognosis in patients treated with radical nephroureterectomy at Memorial Sloan-Kettering Cancer Center. Eur Urol. 2010;58:574–80.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Cosentino M, Palou J, Gaya JM, et al. Upper urinary tract urothelial cell carcinoma: location as a predictive factor for concomitant bladder carcinoma. World J Urol. 2013;31:141–5.

    Article  PubMed  Google Scholar 

  10. Rouprêt M, Yates DR, Comperat E, et al. Upper urinary tract urothelial cell carcinomas and other urological malignancies involved in the hereditary nonpolyposis colorectal cancer (lynch syndrome) tumor spectrum. Eur Urol. 2008;54:1226–36.

    Article  PubMed  Google Scholar 

  11. Green DA, Rink M, Xylinas E, et al. Urothelial carcinoma of the bladder and the upper tract: disparate twins. J Urol. 2013;189:1214–21.

    Article  PubMed  Google Scholar 

  12. Raman JD, Messer J, Sielatycki JA, et al. Incidence and survival of patients with carcinoma of the ureter and renal pelvis in the USA, 1973–2005. BJU Int. 2011;107:1059–64.

    Article  PubMed  Google Scholar 

  13. Hall MC, Womack S, Sagalowsky AI, et al. Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30-year experience in 252 patients. Urology. 1998;52:594–601.

    Article  CAS  PubMed  Google Scholar 

  14. Shariat SF, Favaretto RL, Gupta A, et al. Gender differences in radical nephroureterectomy for upper tract urothelial carcinoma. World J Urol. 2011;29:481–6.

    Article  PubMed  Google Scholar 

  15. Soria F, Shariat SF, Lerner SP, et al. Epidemiology, diagnosis, preoperative evaluation and prognostic assessment of upper-tract urothelial carcinoma (UTUC). World J Urol. 2017;35:379–87.

    Article  PubMed  Google Scholar 

  16. Colin P, Koenig P, Ouzzane A, et al. Environmental factors involved in carcinogenesis of urothelial cell carcinomas of the upper urinary tract. BJU Int. 2009;104:1436–40.

    Article  CAS  PubMed  Google Scholar 

  17. McLaughlin JK, Silverman DT, Hsing AW, et al. Cigarette smoking and cancers of the renal pelvis and ureter. Cancer Res. 1992;52:254–7.

    CAS  PubMed  Google Scholar 

  18. Shinka T, Miyai M, Sawada Y, et al. Factors affecting the occurrence of urothelial tumors in dye workers exposed to aromatic amines. Int J Urol. 1995;2:243–8.

    Article  CAS  PubMed  Google Scholar 

  19. Stefanovic V, Radovanovic Z. Balkan endemic nephropathy and associated urothelial cancer. Nat Clin Pract Urol. 2008;5:105–12.

    Article  PubMed  Google Scholar 

  20. Stefanovic V, Toncheva D, Polenakovic M. Balkan nephropathy. Clin Nephrol. 2015;83(7 Suppl 1):64–9.

    Article  PubMed  Google Scholar 

  21. Jankovic Velickovic L, Hattori T, et al. Upper urothelial carcinoma in Balkan endemic nephropathy and non-endemic regions: a comparative study of pathological features. Pathol Res Pract. 2009;205:89–96.

    Article  PubMed  Google Scholar 

  22. Koornstra JJ, Mourits MJ, Sijmons RH, et al. Management of extracolonic tumours in patients with Lynch syndrome. Lancet Oncol. 2009;10:400–8.

    Article  CAS  PubMed  Google Scholar 

  23. Vashistha V, Shabsigh A, Zynger DL. Utility and diagnostic accuracy of ureteroscopic biopsy in upper tract urothelial carcinoma. Arch Pathol Lab Med. 2013;137:400–7.

    Article  CAS  PubMed  Google Scholar 

  24. Tavora F, Fajardo DA, Lee TK, et al. Small endoscopic biopsies of the ureter and renal pelvis: pathologic pitfalls. Am J Surg Pathol. 2009;33:1540–6.

    Article  PubMed  Google Scholar 

  25. Smith AK, Stephenson AJ, Lane BR, et al. Inadequacy of biopsy for diagnosis of upper tract urothelial carcinoma: implications for conservative management. Urology. 2011;78:82–6.

    Article  PubMed  Google Scholar 

  26. Badalament RA, Kimmel M, Gay H, et al. The sensitivity of flow cytometry compared with conventional cytology in the detection of superficial bladder carcinoma. Cancer. 1987;59:2078–85.

    Article  CAS  PubMed  Google Scholar 

  27. Gregoire M, Fradet Y, Meyer F, et al. Diagnostic accuracy of urinary cytology, and deoxyribonucleic acid flow cytometry and cytology on bladder washings during followup for bladder tumors. J Urol. 1997;157:1660–4.

    Article  CAS  PubMed  Google Scholar 

  28. Mian C, Mazzoleni G, Vikoler S, et al. Fluorescence in situ hybridisation in the diagnosis of upper urinary tract tumours. Eur Urol. 2010;58:288–92.

    Article  PubMed  Google Scholar 

  29. Liang JF, Zheng HX, Li N, et al. Fluorescent microsatellite analysis of urine sediment in patients with urothelial carcinoma. Urol Int. 2010;85:296–303.

    Article  PubMed  Google Scholar 

  30. Moch H, Humphrey PA, Ulbright TM, et al., editors. World Health Organization Classification of tumours of the urinary system and male genital organs. 4th ed. Lyon: IARC Press; 2016. p. 77–133.

    Google Scholar 

  31. McKiernan JM, Hansel DE, Bochner BH, et al. Renal pelvis and ureter. In: Amin MB, Edge SB, Greene FL, et al., editors. AJCC cancer staging manual. 8th ed. Berlin: Springer; 2017. p. 749–55.

    Google Scholar 

  32. Kanamori S, Okumura S, Nishimura T, et al. Papilloma of renal pelvis in childhood. Urology. 1990;35:523–5.

    Article  CAS  PubMed  Google Scholar 

  33. Dounis A, Mitropoulos D. Recurrence of papilloma of renal pelvis on ureteral stump thirty years after nephrectomy. Urology. 1988;32:50–1.

    Article  CAS  PubMed  Google Scholar 

  34. Luo JD, Wang P, Chen J, et al. Upper urinary tract inverted papillomas: report of 10 cases. Oncol Lett. 2012;4:71–4.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Spevack L, Herschorn S, Srigley J. Inverted papilloma of the upper urinary tract. J Urol. 1995;153:1202–4.

    Article  CAS  PubMed  Google Scholar 

  36. Holmäng S, Johansson SL. Urothelial carcinoma of the upper urinary tract: comparison between the WHO/ISUP 1998 consensus classification and WHO 1999 classification system. Urology. 2005;66:274–8.

    Article  PubMed  Google Scholar 

  37. Maxwell JP, Wang C, Wiebe N, et al. Long-term outcome of primary Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) including PUNLMP with inverted growth. Diagn Pathol. 2015;10:3. https://doi.org/10.1186/s13000-015-0234-z.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Hartmann A, Dietmaier W, Hofstädter F, et al. Urothelial carcinoma of the upper urinary tract: inverted growth pattern is predictive of microsatellite instability. Hum Pathol. 2003;34:222–7.

    Article  PubMed  Google Scholar 

  39. Mostofi FK, Sobin LH, Torloni H. Histological typing of urinary bladder tumours. Geneva: World Health Organization; 1973.

    Google Scholar 

  40. May M, Brookman-Amissah S, Roigas J, et al. Prognostic accuracy of individual uropathologists in noninvasive urinary bladder carcinoma: a multicentre study comparing the 1973 and 2004 World Health Organisation classifications. Eur Urol. 2010;57:850–8.

    Article  PubMed  Google Scholar 

  41. Redrow GP, Guo CC, Brausi MA, et al. Upper urinary tract carcinoma in situ: current knowledge, Future Direction. J Urol. 2017;197:287–95.

    Article  PubMed  Google Scholar 

  42. Lughezzani G, Jeldres C, Isbarn H, et al. Temporal stage and grade migration in surgically treated patients with upper tract urothelial carcinoma. BJU Int. 2010;105:799–804.

    Article  PubMed  Google Scholar 

  43. Rouprêt M, Babjuk M, Compérat E, et al. European Association of Urology Guidelines on upper urinary tract urothelial cell carcinoma: 2015 update. Eur Urol. 2015;68:868–79.

    Article  PubMed  Google Scholar 

  44. Martin JE, Jenkins BJ, Zuk RJ, et al. Clinical importance of squamous metaplasia in invasive transitional cell carcinoma of the bladder. J Clin Pathol. 1989;42:250–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Perez-Montiel D, Wakely PE, Hes O, et al. High-grade urothelial carcinoma of the renal pelvis: clinicopathologic study of 108 cases with emphasis on unusual morphologic variants. Mod Pathol. 2006;19:494–503.

    Article  PubMed  Google Scholar 

  46. Rink M, Robinson BD, Green DA, et al. Impact of histological variants on clinical outcomes of patients with upper urinary tract urothelial carcinoma. J Urol. 2012;188:398–404.

    Article  PubMed  Google Scholar 

  47. Blacher EJ, Johnson DE, Abdul-Karim FW, et al. Squamous cell carcinoma of renal pelvis. Urology. 1985;25:124–6.

    Article  CAS  PubMed  Google Scholar 

  48. Gulmann C, Paner GP, Parakh RS, et al. Immunohistochemical profile to distinguish urothelial from squamous differentiation in carcinomas of urothelial tract. Hum Pathol. 2013;44:164–72.

    Article  CAS  PubMed  Google Scholar 

  49. Holmäng S, Lele SM, Johansson SL. Squamous cell carcinoma of the renal pelvis and ureter: incidence, symptoms, treatment and outcome. J Urol. 2007;178:51–6.

    Article  PubMed  Google Scholar 

  50. Lai C, Teng XD. Primary enteric-type mucinous adenocarcinoma of the renal pelvis masquerading as cystic renal cell carcinoma: a case report and review of the literature. Pathol Res Pract. 2016;212:842–8.

    Article  PubMed  Google Scholar 

  51. Ye YL, Bian J, Huang YP, et al. Primary mucinous adenocarcinoma of the renal pelvis with elevated CEA and CA19-9. Urol Int. 2011;87:484–8.

    Article  PubMed  Google Scholar 

  52. Si Q, Dancer J, Stanton ML, et al. Small cell carcinoma of the kidney: a clinicopathologic study of 14 cases. Hum Pathol. 2011;42:1792–8.

    Article  PubMed  Google Scholar 

  53. Miller RJ, Holmäng S, Johansson SL, et al. Small cell carcinoma of the renal pelvis and ureter: clinicopathologic and immunohistochemical features. Arch Pathol Lab Med. 2011;135:1565–9.

    Article  PubMed  Google Scholar 

  54. Nowak MA, Marzich CS, Scheetz KL, et al. Benign fibroepithelial polyps of the renal pelvis. Arch Pathol Lab Med. 1999;123:850–2.

    CAS  PubMed  Google Scholar 

  55. Tamboli P, Ro JY, Amin MB, et al. Benign tumors and tumor-like lesions of the adult kidney. Part II: benign mesenchymal and mixed neoplasms, and tumor-like lesions. Adv Anat Pathol. 2000;7:47–66.

    Article  CAS  PubMed  Google Scholar 

  56. Rigola MA, Fuster C, Casadevall C, et al. Comparative genomic hybridization analysis of transitional cell carcinomas of the renal pelvis. Cancer Genet Cytogenet. 2001;127:59–63.

    Article  CAS  PubMed  Google Scholar 

  57. Sfakianos JP, Cha EK, Iyer G, et al. Genomic characterization of upper tract urothelial carcinoma. Eur Urol. 2015;68(6):970–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Moss TJ, Qi Y, Xi L, et al. Comprehensive genomic characterization of upper tract urothelial carcinoma. Eur Urol. 2017;72:641–9.

    Article  CAS  PubMed  Google Scholar 

  59. Raman JD, Scherr DS. Management of patients with upper urinary tract transitional cell carcinoma. Nat Clin Pract Urol. 2007;4:432–43.

    Article  PubMed  Google Scholar 

  60. Roscigno M, Shariat SF, Margulis V, et al. Impact of lymph node dissection on cancer specific survival in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy. J Urol. 2009;181:2482–9.

    Article  PubMed  Google Scholar 

  61. Schnapp DS, Weiss GH, Smith AD. Fever following intracavitary bacillus Calmette-Guerin therapy for upper tract transitional cell carcinoma. J Urol. 1996;156:386–8.

    Article  CAS  PubMed  Google Scholar 

  62. Seisen T, Krasnow RE, Bellmunt J, et al. Effectiveness of adjuvant chemotherapy after radical mephroureterectomy for locally advanced and/or positive regional lymph node upper tract urothelial carcinoma. J Clin Oncol. 2017;35:852–60.

    Article  PubMed  Google Scholar 

  63. Mbeutcha A, Rouprêt M, Kamat AM, et al. Prognostic factors and predictive tools for upper tract urothelial carcinoma: a systematic review. World J Urol. 2017;35:337–53.

    Article  CAS  PubMed  Google Scholar 

  64. Zigeuner R, Shariat SF, Margulis V, et al. Tumour necrosis is an indicator of aggressive biology in patients with urothelial carcinoma of the upper urinary tract. Eur Urol. 2010;57:575–81.

    Article  CAS  PubMed  Google Scholar 

  65. Kondo T, Nakazawa H, Ito F, et al. Primary site and incidence of lymph node metastases in urothelial carcinoma of upper urinary tract. Urology. 2007;69:265–9.

    Article  PubMed  Google Scholar 

  66. Humphrey PA, Moch H, Cubila AL, et al. The 2016 WHO Classification of tumours of the urinary system and male genital organs—part B: prostate and bladder tumours. Eur Urol. 2016;70:106–19.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Charles C. Guo .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Guo, C.C., Zhang, M., Sircar, K. (2020). Tumors of the Renal Pelvis. In: Divatia, M., Ozcan, A., Guo, C., Ro, J. (eds) Kidney Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-28333-9_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-28333-9_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-28332-2

  • Online ISBN: 978-3-030-28333-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics