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 characteristically presenting with advanced stage. Most patients have a history of chronic urolithiasis, renal infection or abuse of analgesics. A 52-year-old male patient presented to our emergency department with left flank pain and the signs of acute renal failure. He had a history of untreated renal calculi. After appropriate conservative management and two sessions of hemodialysis, extensive investigations demonstrated splenic hematoma extending to the superior surface of the enlarged left kidney without a remarkable mass size. Percutaneous renal biopsy revealed squamous cell carcinoma of the left kidney. Herein we report a case of RSCC presenting with intracapsular hematoma of the spleen, thought to be the invasion of the tumor at the left kidney. The possibility of malignancy should always be kept mind when identifying controversial clinical signs and subtle imaging findings in patients with long standing untreated urolithiasis.