Squamous cell carcinoma of renal pelvis presenting as pyelo-entero-cutaneous fistula: case report and review of literature

Objective: Squamous cell carcinoma (SCC) of renal pelvis is a subtle tumor and pyelo-enteric and pyelo-cutaneous fistula has remotely been identified as its clinical presentation. This unseal clinical scenario is a diagnostic and management dissention. Method: We report a rare case of squamous cell carcinoma of the renal pelvis presenting as pyelo-enterocutaneous fistula in a patient with long standing staghorn calculus. Result: Renal SCC can present without evidence of a distinct mass and it may closely mimic chronic inflammatory conditions like xanthogranulomatous pyelonephritis. Inconclusive clinical and radiological traits confounded by rarity, often delay the diagnosis. Majority of patients present with locally advanced or metastatic disease leading to poor survival. The diagnosis of SCC of renal pelvis was made on post surgery pathological examination. Conclusion: Renal SCC must be kept in mind as an important differential diagnosis in patient with non-resolving fistulas associated with chronic stone disease. These patients should be scrutinized with strong clinical suspicion with newer imaging techniques to aid in timely diagnosis in order to deter poor survival in these