Neoplasms of the renal pelvis account for approximately 7-8% of all renal malignancies, and most such neoplasms are urothelial in origin. Among these malignancies, the most common type is urothelial carcinoma, followed by squamous cell carcinoma. Primary adenocarcinoma of the renal pelvis is an extremely rare type, with only a few case reports in the literature. It may occur as a result of metaplasia of the renal pelvic transitional epithelium into glandular epithelium due to longstanding obstruction and infection and chronic irritation by urolithiasis, which then undergoes a malignant transformation. Herein, we report a case and the image findings of primary adenocarcinoma of the renal pelvis in a 50-year-old woman with history of renal calculi and end-stage renal disease.
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