Squamous Cell Carcinoma of the Renal Pelvis

The patient is a 46-year-old female with a history of chronic kidney disease and bilateral nephrolithiasis status post extracorporeal shockwave lithotripsy and multiple endoscopic procedures who presented with a malignancy of unknown origin. Approximately 1 month before her current admission, the patient underwent an elective right percutaneous nephrolithotomy. Three weeks after her discharge, the patient presented to an outside hospital with fever, chills, vomiting, and abdominal pain. She was admitted and treated for pyelonephritis. Cross-sectional imaging, completed during her hospital stay, was significant for hilar and mediastinal adenopathy, as well as a suspicious lung infiltrate. Fine needle aspiration of the mediastinal adenopathy was performed, and pathology was consistent with a poorly differentiated squamous cell carcinoma (SCC). Subsequently, the patient was referred to our institution for further evaluation and treatment.