Context: Keratinizing desquamative squamous metaplasia (KDSM) of the upper urinary tract was previously thought, but never proven, to represent a premalignant condition. However, no clear guidelines exist regarding the long-term management and follow up once this rare diagnosis has been made.

Findings: Patients with spinal cord injury often develop a range of risk factors for malignancy of the urinary tract. We present the first reported case of KDSM in the kidney of a 44-year-old man with spinal cord injury whose complex urological history includes previous augmentation cystoplasty, recurrent calculi, infections and indwelling catheters.

Clinical Relevance: Recent literature has suggested a move away from the previous mainstay of treatment with radical surgery towards nephron-sparing endoscopic and radiological surveillance. This case highlights the complexity of preserving renal function in a spinal cord injured patient with KDSM of the kidney.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5072503PMC
http://dx.doi.org/10.1080/10790268.2016.1139291DOI Listing

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