What question did this study set out to answer?

The aim is to highlight the aggressive nature of sarcomatoid urothelial carcinoma and associated symptoms.

July 3, 2026Urology Case Reports0 citationsOpen Access

Sarcomatoid Urothelial Carcinoma of the Renal Pelvis: A Case Report and Literature Review

Key Points

The aim is to highlight the aggressive nature of sarcomatoid urothelial carcinoma and associated symptoms.
Case report of a 67-year-old man with persistent symptoms and renal pelvic mass.
Radical nephroureterectomy performed after initial antimicrobial therapy and drainage did not resolve his symptoms.
Follow-up included CT imaging to assess for metastases.
The patient experienced recurrent fever and leukocytosis post-surgery, indicating tumor activity.
CT imaging at 3 months post-surgery revealed multiple intra-abdominal metastases.
Patient succumbed to the disease 4 months after undergoing the nephroureterectomy.

Abstract

Sarcomatoid urothelial carcinoma (SUC) of the renal pelvis is a rare, highly aggressive upper tract urothelial carcinoma variant. We report a 67-year-old man with persistent fever, gross hematuria, leukocytosis, and a renal pelvic mass with hydronephrosis and calculi. Fever persisted despite antimicrobial therapy and nephrostomy drainage until radical nephroureterectomy was performed. Postoperatively, fever and inflammatory indices normalized but recurred 1 month later; by 3 months, CT showed multiple intra-abdominal metastases with leukocytosis and neutrophilia. The patient died 4 months after surgery. This case suggests that persistent or recurrent fever with leukocytosis may reflect tumor activity rather than infection.

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