Squamous Cell Carcinoma of the Left Kidney Presenting with Splenic Hematoma

Renal squamous cell carcinoma (RSCC) is a rare malignancy of the upper urinary tract characteristicallypresenting with advanced stage. Most patients have a history of chronic urolithiasis, renal infection or abuseof analgesics. A 52-year-old male patient presented to our emergency department with left flank pain andthe signs of acute renal failure. He had a history of untreated renal calculi. After appropriate conservativemanagement and two sessions of hemodialysis, extensive investigations demonstrated splenic hematomaextending to the superior surface of the enlarged left kidney without a remarkable mass size. Percutaneousrenal biopsy revealed squamous cell carcinoma of the left kidney. Herein we report a case of RSCC presentingwith intracapsular hematoma of the spleen, thought to be the invasion of the tumor at the left kidney. Thepossibility of malignancy should always be kept mind when identifying controversial clinical signs and subtleimaging findings in patients with long standing untreated urolithiasis.