Cardiac Metastasis in Upper Tract Urothelial Carcinoma with Squamous Differentiation

Figures

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  Fig. 1.. Dynamic renal scintigraphy showing right-sided parenchymal uptake and excretion. Sequential frames demonstrate preserved perfusion and excretion function of the right kidney over a 20-min acquisition period. The left renal unit is absent, consistent with history of left nephroureterectomy.

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  Fig. 2.. Gross specimen of the left nephroureterectomy showing an irregular, friable tumor involving the renal pelvis and extending into the proximal ureter. The mass appears hemorrhagic and infiltrative, consistent with high-grade urothelial carcinoma with squamous differentiation.

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  Fig. 3.. Gross pathological specimen demonstrating a large, exophytic renal pelvic tumor with extensive invasion into the renal parenchyma and proximal ureter. The mass exhibits a nodular, necrotic, and hemorrhagic appearance, characteristic of high-grade urothelial carcinoma with squamous differentiation.

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  Fig. 4.. Gross specimen of the nephroureterectomy showing an enlarged kidney with intact Gerota’s fascia and an extended ureter down to the bladder cuff. The external surface appears bosselated and tense, reflecting the underlying high-grade urothelial carcinoma.

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  Fig. 5.. Cut section of the nephrectomy specimen revealing a heterogeneous intrarenal mass with areas of necrosis, hemorrhage, and tan-white solid components consistent with high-grade urothelial carcinoma with squamous differentiation.

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  Fig. 6.. A possible mass or abnormality of the renal pelvis and upper ureter, which correlates with UTUC involving the right kidney.

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  Fig. 7.. Mass-like opacity in the right atrial, which aligns with the suspected cardiac metastasis.

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  Fig. 8.. Asymmetric soft tissue density in the pelvic region, likely representing local recurrence or a metastatic focus.

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  Fig. 9.. Axial contrast-enhanced CT image in the venous phase demonstrating a heterogeneously enhancing mass involving the left kidney, suggestive of renal malignancy with central necrosis and distortion of the renal architecture.

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  Fig. 10.. Axial contrast-enhanced CT image in the venous phase showing an enlarged left kidney with an infiltrative mass and loss of normal corticomedullary differentiation, consistent with advanced renal malignancy.

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  Fig. 11.. Chest X-ray (posteroanterior view) showing right lower lung field opacification with obscuration of the right hemidiaphragm, suggestive of pleural effusion or lower lobe pathology. The cardiac silhouette appears enlarged, with irregular contouring along the right ventricular border. Central lines or tubes are also visible.