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1
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Guan HY, Wang J, Wang JX, Chen QH, Lu J, He L. Renal pelvis sarcomatoid carcinoma with renal vein tumor thrombus: A case report and literature review. World J Clin Cases 2023; 11:7690-7698. [DOI: 10.12998/wjcc.v11.i31.7690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/06/2023] [Accepted: 10/26/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Renal pelvis sarcomatoid carcinoma (RPSC) is a rare and aggressive malignancy whose diagnosis is difficult because radiological imaging results can lead to misclassification as a more common type of renal tumor. In addition, clinical management of patients with RPSC is difficult because of the limited efficacy of available treatments. In this study, we present a comprehensive description of a patient who presented with RPSC and a simultaneous renal vein tumor thrombus.
CASE SUMMARY During April, 2020, a 64-year-old female presented with an isolated episode of hematuria accompanied by abdominal pain. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a lesion in the right renal pelvis. We therefore performed a radical nephrectomy of the right kidney. The subsequent histopathological and immunological results verified the diagnosis of RPSC. Despite administration of 6 cycles of a gemcitabine-cisplatin regimen, the patient's condition progressively deteriorated, and she died about 15 mo after the nephrectomy.
CONCLUSION We performed a comprehensive analysis of a patient with RPSC that included CT, MRI, immunohistochemistry, and genetic testing. The insights from our detailed analysis of this patient and our concomitant review of the literature may assist clinicians in their diagnosis and treatment of RPSC.
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Affiliation(s)
- Huai-Yong Guan
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
| | - Jin Wang
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
| | - Ji-Xue Wang
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
| | - Qi-Hui Chen
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
| | - Ji Lu
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
| | - Liang He
- Department of Urology, Jilin University First Hospital, Changchun 130000, Jilin Province, China
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2
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Hacıosmanoğlu T, Baloğlu İH, Türk S, Demirel HC, Özağarı AA. Carcinosarcoma Arising From the Renal Pelvis: A Rare Case Report. Cureus 2023; 15:e45610. [PMID: 37868428 PMCID: PMC10588731 DOI: 10.7759/cureus.45610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Carcinosarcoma is a malignant tumor of biphasic character consisting of epithelial and mesenchymal components. This rarely-seen tumor has an exceedingly aggressive nature. While it is rare in the urinary system, it appears even more rarely in the renal pelvis. Thus, there are few publications in the literature on carcinosarcomas originating from the renal pelvis. This paper presents a 42-year-old male patient with carcinosarcoma of the renal pelvis (CSRP), kidney stone disease, and a nephrocutaneous fistula who underwent radical nephrectomy and eventually died of metastatic disease. The rarity of the disease is the main obstacle to conducting comprehensive clinical trials. Therefore, it is of great importance to publish the identified carcinosarcoma of the renal pelvis cases.
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Affiliation(s)
- Taner Hacıosmanoğlu
- Department of Urology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, TUR
| | - İbrahim H Baloğlu
- Department of Urology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, TUR
| | - Semih Türk
- Department of Urology, Sultan 1. Murat State Hospital, Edirne, TUR
| | - Hüseyin C Demirel
- Department of Urology, Istanbul Aydin University VM Medical Park Florya Hospital, Istanbul, TUR
| | - Ayşe A Özağarı
- Department of Pathology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, TUR
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3
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Takemura K, Motoi T, Tonooka A, Funata N, Nakanishi Y, Kataoka M, Ito M, Sakamoto K, Suzuki H, Tobisu KI, Koga F. Multifocal Synchronous Upper Urinary Tract Carcinosarcoma (Sarcomatoid Carcinoma) With Rhabdomyoblastic Differentiation. Int J Surg Pathol 2019; 27:547-552. [PMID: 30767589 DOI: 10.1177/1066896919828111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Carcinosarcoma of the upper urinary tract is very rare. In this article, we report a case of upper urinary tract carcinosarcoma with rhabdomyoblastic differentiation showing distinct transition between the epithelial and mesenchymal components confirmed by morphology and immunohistochemistry. An 81-year-old female underwent radical nephroureterectomy under the diagnosis of left ureteral urothelial carcinoma (UC). Multiple invasive tumors showed combined histology with UC and rhabdomyosarcomatous elements (pT2-ureter and pT3-renal pelvis, pN0, u-lt0, ly0, v0, RM0). Each element demonstrated typical epithelial or mesenchymal staining patterns (positive for AE1/AE3 in the former and positive for vimentin and myogenin in the latter). Notably, immunohistochemical transition patterns of GATA-3, p63, SOX2, and myogenin between UC and rhabdomyosarcomatous elements were observed, implying possible involvement of neoplastic stem cells in the process of carcinosarcoma formation. The patient did not receive any adjuvant therapy and eventually succumbed to multiple visceral metastases (lungs and liver) at 11 months postoperatively. No autopsy was performed.
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Affiliation(s)
- Kosuke Takemura
- 1 Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Toru Motoi
- 2 Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Akiko Tonooka
- 2 Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Nobuaki Funata
- 2 Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yasukazu Nakanishi
- 1 Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Madoka Kataoka
- 1 Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Masaya Ito
- 1 Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kazumasa Sakamoto
- 1 Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hiroaki Suzuki
- 1 Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Ken-Ichi Tobisu
- 1 Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Fumitaka Koga
- 1 Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
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4
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Dong B, Zhang JJ, Chen C, Wang YT, Zhai XY, Fu YW, Zhou HL. Diagnosis and treatment of carcinosarcoma of the renal pelvis: A case report. Oncol Lett 2014; 8:467-469. [PMID: 24959298 PMCID: PMC4063624 DOI: 10.3892/ol.2014.2145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 04/29/2014] [Indexed: 11/06/2022] Open
Abstract
Carcinosarcoma is a rare type of renal pelvis malignancy, the diagnosis of which requires the presence of malignant epithelial and mesenchymal components. The prognosis of this disease is extremely poor due to its rapid progression and widespread metastases. The present study describes a case of carcinosarcoma involving the right renal pelvis in a 73-year-old female who presented with intermittent hematuria and right-flank pain that had persisted for one month. Computed tomography revealed a 2.4×2.5 cm mass in the right renal pelvis, which was diagnosed as a right renal pelvic tumor. Laparoscopic radical resection of the right kidney and ureter was performed. Following surgery, immunohistochemical analysis showed positive reactions for epithelial and mesenchymal markers. Based on these findings, the patient was diagnosed with carcinosarcoma. Thus, immunohistochemical analysis is a critical method for the accurate diagnosis of carcinosarcoma.
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Affiliation(s)
- Biao Dong
- Department of Urology, First Hospital of Jilin University, Jilin, Changchun 130021, P.R. China
| | - Jian-Jian Zhang
- Department of Hepatic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China
| | - Chao Chen
- Department of Critical Care Medicine, Henan Province People's Hospital, Zhengzhou, Henan 450003, P.R. China
| | - Yuan-Tao Wang
- Department of Urology, First Hospital of Jilin University, Jilin, Changchun 130021, P.R. China
| | - Xiu-Yu Zhai
- Department of Urology, First Hospital of Jilin University, Jilin, Changchun 130021, P.R. China
| | - Yao-Wen Fu
- Department of Urology, First Hospital of Jilin University, Jilin, Changchun 130021, P.R. China
| | - Hong-Lan Zhou
- Department of Urology, First Hospital of Jilin University, Jilin, Changchun 130021, P.R. China
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5
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Chen S, Chen G, Xia D, Li J, Wang S, Shen B, Jin B. Sarcomatoid carcinoma of the renal pelvis: Experience of multiple cases over a ten-year period. Oncol Lett 2013; 6:513-516. [PMID: 24137357 PMCID: PMC3788826 DOI: 10.3892/ol.2013.1396] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 05/15/2013] [Indexed: 11/06/2022] Open
Abstract
Sarcomatoid carcinoma of the renal pelvis is a rare clinical entity. To the best of our knowledge, only 14 cases of this type of neoplasm have been reported in the literature to date. In the present study, the records at The First Affiliated Hospital, Medicine School of Zhejiang University (Hangzhou, Zhejiang, China) between 2000 and 2010 were reviewed to identify patients with primary renal pelvis sarcomatoid carcinoma (RPSC). A particular emphasis was placed on the treatment, recurrence and survival outcome. Eight patients with RPSC were identified and treated with nephrectomy or nephroureterectomy. All of the patients presented with Grade 3 RPSC. According to the TNM classification system, 2 patients were in stage pT2, 5 in stage pT3 and 1 in stage pT4. Adjuvant chemotherapy was administered to four patients, and the mean follow-up period was 27.5±41.0 months. In total, 6 patients succumbed to the disease with a mean survival time of 7.7±5.3 months (range, 1-18 months), while 2 patients were free of disease at 54 and 120 months, respectively, following treatment. The mean disease-specific survival time was 27.5±41.0 months and the 1-year recurrence-free survival, 1-year survival and overall survival rates were 37.5, 37.5 and 25%, respectively. The present analysis suggests a poor prognosis for the majority of RPSC patients, most likely resulting from the advanced stage of the disease at diagnosis and a poor response to systemic therapy. To improve the survival rate of RPSC, it is therefore essential to perform an early diagnosis and early radical surgery. Intravesical instillation is not essential following surgery.
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Affiliation(s)
- Shanwen Chen
- Departments of Urology, Medical School of Zhejiang University, Hangzhou, Zhejiang 310031, P.R. China
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6
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Coz F, Vivaldi B, Zambrano N, Domenech A, Schiappacasse G, Retamal Y, Maurin C. Carcinosarcome du bassinet sur rein en fer à cheval : à propos d’un cas. Prog Urol 2012; 22:360-2. [DOI: 10.1016/j.purol.2011.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Accepted: 11/14/2011] [Indexed: 11/27/2022]
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7
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Pusiol T, Morichetti D, Zorzi MG, Piscioli F. Carcinosarcoma of the renal pelvis: inaccurate documentation of origin and incomplete review of the literature. Ren Fail 2011; 33:844-5. [PMID: 21770852 DOI: 10.3109/0886022x.2011.594531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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8
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Chiu KC, Lin MC, Liang YC, Chen CY. Renal carcinosarcoma: case report and review of literature. Ren Fail 2009; 30:1034-9. [PMID: 19016157 DOI: 10.1080/08860220802403192] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Carcinosarcoma is a malignancy that occurs very rarely in the renal pelvis, and only a very limited number of cases has been documented. These tumors are composed of both malignant mesenchymal and epithelial elements. Unlike the cases described so far, this carcinosarcoma of the renal pelvis was characterized by quick recurrence, following complete surgical resection. Carcinosarcomas of the renal pelvis are known to be rapid in progression and associated with a poor prognosis. They usually metastasize soon after surgery, but very little information is available on the histologic types that characterize the recurrent tumors. We presented a histologically proven case of renal carcinosarcoma extending from renal pelvis. Convalescence was uneventful, and fifteen months after the operation, he is alive with no recurrence or metastasis. If a rapidly growing tumor is detected that seems to originate from the kidney with extension to ureter and bladder, carcinosarcoma should be included in the differential diagnosis.
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Affiliation(s)
- Kuan-Chi Chiu
- Department of Radiology, Tainan Municipal Hospital, Tian-Sheng Memorial Hospital, Tong-Kang, Ping-Tong, Taiwan, ROC
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9
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Hisataki T, Takahashi A, Taguchi K, Shimizu T, Suzuki K, Takatsuka K, Iwaki H. Sarcomatoid transitional cell carcinoma originating from a duplicated renal pelvis. Int J Urol 2001; 8:704-6. [PMID: 11851772 DOI: 10.1046/j.1442-2042.2001.00396.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A case of sarcomatoid transitional cell carcinoma of the renal pelvis is reported. It was distinguished from carcinosarcoma by immunohistochemical study. The tumor was difficult to distinguish from a renal parenchymal tumor in imaging studies because it originated from a duplicated renal pelvis.
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Affiliation(s)
- T Hisataki
- Department of Urology, Sunagawa City Medical Center, Sunagawa, Japan.
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10
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Chao D, Zisman A, Freedland SJ, Pantuck AJ, Said JW, Belldegrun AS. Sarcomatoid renal cell carcinoma. Urol Oncol 2001. [DOI: 10.1016/s1078-1439(01)00125-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Abstract
Carcinosarcoma of the renal pelvis is a rare neoplasm, with 7 cases reported. This lesion should be differentiated from a sarcomatoid variant of renal cell carcinoma; it is usually associated with a poor prognosis. We report an additional case of renal pelvic carcinosarcoma.
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Affiliation(s)
- R J Dimitriou
- Department of Urology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA
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12
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Lopez-Beltran A, Escudero AL, Cavazzana AO, Spagnoli LG, Vicioso-Recio L. Sarcomatoid transitional cell carcinoma of the renal pelvis. A report of five cases with clinical, pathological, immunohistochemical and DNA ploidy analysis. Pathol Res Pract 1996; 192:1218-24. [PMID: 9182292 DOI: 10.1016/s0344-0338(96)80154-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Sarcomatoid transitional cell carcinoma of the renal pelvis is a rare neoplasm with only 7 well illustrated examples reported. These tumours can assume a partial or complete spindle cell pattern of growth, leading to the erroneous classification as sarcomas. We describe the clinic-pathologic features of five additional examples of sarcomatoid carcinoma of the renal pelvis observed in three males and two females. The age ranged from 65-to-82 years-old (mean 71.6). All these patients were treated by nephrectomy and died of disease between 6 and 20 months (mean 11.2) after the onset of symptoms. An immunohistochemical study demonstrated coexpression of keratins, epithelial membrane antigen and vimentin. The image DNA ploidy of all the tumours showed an aneuploid pattern.
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Affiliation(s)
- A Lopez-Beltran
- Department of Pathology, Cordoba University Medical School, Spain
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13
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Orsatti G, Corgan FJ, Goldberg SA. Carcinosarcoma of urothelial organs: sequential involvement of urinary bladder, ureter, and renal pelvis. Urology 1993; 41:289-91. [PMID: 8442318 DOI: 10.1016/0090-4295(93)90579-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We report a case of true carcinosarcoma involving the urinary bladder, ureter, and renal pelvis in an eighty-year-old man. The patient underwent transurethral resection of the bladder tumor and left nephrectomy, followed by combination chemo- and radiotherapy. He died eighteen months after the nephrectomy.
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Affiliation(s)
- G Orsatti
- Department of Pathology, Staten Island University Hospital, New York
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14
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Kragel PJ, Travis WD, Luibel FJ. Sarcomatoid renal carcinoma with angiosarcomatoid component. Light microscopic and immunohistochemical study. Urology 1992; 40:381-4. [PMID: 1413363 DOI: 10.1016/0090-4295(92)90396-e] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We describe a case of primary renal pelvic carcinoma which showed an unusual histologic pattern of anastomosing blood-filled channels lined by atypical cells. This angiosarcomatoid pattern merged with solid areas typical of renal carcinoma. Immunoperoxidase stains for cytokeratin and epithelial membrane antigen were positive in both the angiosarcomatoid and typical carcinomatous areas, while stains for factor VIII-related antigen and desmin were negative. Since primary renal angiosarcomas are rare neoplasms, the diagnosis of sarcomatoid renal carcinoma should be considered in primary renal neoplasms which show this angiosarcomatoid pattern.
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Affiliation(s)
- P J Kragel
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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15
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Tajima Y, Aizawa M. Unusual renal pelvic tumor containing transitional cell carcinoma, adenocarcinoma and sarcomatoid elements (so-called sarcomatoid carcinoma of the renal pelvis). A case report and review of the literature. ACTA PATHOLOGICA JAPONICA 1988; 38:805-14. [PMID: 2851258 DOI: 10.1111/j.1440-1827.1988.tb02352.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A case of sarcomatoid carcinoma of the renal pelvis in a 66-year-old male is reported. The patient underwent left nephroureterectomy because of renal pelvic tumor and hydronephrosis. Left renal calcification and atrophy had been diagnosed in the patient about thirty years previously. The tumor showed a polypoid configuration and occupied the renal calyces. Histologically, not only solid nests of transitional cell carcinoma (TCC) and adenocarcinomatous glands but also large spindle-shaped cells with bizarre nuclei simulating sarcoma were identified. Immunoreactive keratin and epithelial-membranous antigen (EMA) were demonstrated in the sarcomatoid cells, indicating that they were of epithelial origin. So far, only 10 cases of so-called sarcomatoid carcinoma or carcinosarcoma of the renal pelvis have been reported in the world. In this report, we summarize the pathological findings of previously reported cases and discuss the histogenesis of this rare tumor.
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Affiliation(s)
- Y Tajima
- First Department of Pathology, Hokkaido University School of Medicine, Sapporo, Japan
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16
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Abstract
A new case of carcinosarcoma of the renal pelvis is reported and the literature reviewed. This tumor occurs in patients over sixty years of age. Three patients died of the disease in one year, and 2 showed six-month and two-year disease-free survival after nephrectomy.
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17
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Tarry WF, Morabito RA, Belis JA. Carcinosarcoma of the renal pelvis with extension into the renal vein and inferior vena cava. J Urol 1982; 128:582-5. [PMID: 7120569 DOI: 10.1016/s0022-5347(17)53054-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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18
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Juhász J, Sebök J, Galambos J, Kiss P. Renal carcinosarcoma (mixed tumours) of the kidney. Int Urol Nephrol 1980; 12:103-8. [PMID: 7228564 DOI: 10.1007/bf02089347] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Abstract
An unusual heterologous carcinosarcoma of the renal pelvis is reported. The differential diagnosis, problems related to nomenclature and histogenetic implications of this rare neoplasm are discussed.
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22
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23
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De La Peña A, Navarro M, Pobil JL, Melicow MM, Uson AC. Concomitant unrelated neoplasms of the renal pelvis. J Urol 1968; 99:21-4. [PMID: 5637227 DOI: 10.1016/s0022-5347(17)62635-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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