Keratinizing desquamative squamous metaplasia in the kidney of a patient with complex spinal cord injury.

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.