Abstract：Objective: To discuss the clinical characteristics of urothelical carcinoma with renal parenchyma spread, and reduce misdiagnosis. Methods: The clinical data of 14 cases of uothelical carcinoma with renal parenchyma spread in our department from December 2011 to May 2015 were retrospectively analyzed, and the clinical characteristics of the uothelical carcinoma with renal parenchyma spread were discussed. All patients were followed up. Results: Of the 14 cases, there were 9 cases of renal pelvis tumors clearly diagnosed preoperatively, 3 cases of middiagnosed renal parenchymal neoplasms, 1 case of middiagnosed xanthogranulomatous pyelonephritis, and one case of ureter carcinoma in situ that was proved as urothelical carcinoma with renal parenchyma spread by postoperative pathology during radical total cystectomy. In 13 cases receiving surgical treatments, there were 12 cases of high-level urothelical carcinoma (including one case of squamous metaplasia), and 1 case of low-level urothelical carcinoma. One case gave up surgical treatment. During the follow-up period of 5 to 47 months, 9 cases died because of tumor progression. Conclusions: Imaging of urothelical carcinoma with renal parenchyma spread is atypical and it is easy to be diagnosed as renal parenchymal neoplasms or inflammation. If urothelical carcinoma cannot be excluded, frozen section during operation is useful. Urothelical carcinoma with renal parenchyma spread has high degree of malignancy and its prognosis is poorer.
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