Squamous cell carcinoma of the renal pelvis with stones and inferior vena cava infiltration. Case report

We report a rare case of a 50 year old man with renal squamous cell carcinoma (SCC) who first came to our attention with renal colic and fever not responding to antibiotic or analgesic treatment. He had a long history of kidney stones, but had not undergone any imaging in the last 5 years. Physical examination revealed tenderness and a palpable mass in the right flank and lumbar region. A whole body CT scan was performed, revealing an 11 cm mass in the right kidney infiltrating the inferior vena cava. There were areas of calcification within the mass and multiple stones within the renal pelvis. The tumor was considered unsuitable for resection according to radiological and clinical criteria. The mass was biopsied percutaneously under CT guidance and histological examination revealed squamous cell carcinoma of the renal pelvis. The patient was treated with neoadjuvant chemotherapy and embolization of the renal artery. He died one month after diagnosis. To our knowledge this is the second reported case in the world of renal SCC infiltrating the inferior vena cava and with kidney stones.

Endoscopic treatment of difficult choledocholithiasis

Common bile duct stones can be treated with normal endoscopic techniques. Where stones cannot be removed due to their size or number or due to stenosis of the common bile duct, a plastic stent can be inserted, enabling rapid drainage of bile. At the three-month check-up complete removal of the stones was found in 41 (85.4%) of the 48 patients with difficult choledocholithiasis. In the remaining 7 patients (14.6%), the stent in any case resulted in clinical improvement. A permanent stent was necessary in 4 patients, enabling safe drainage with no complications. The use of endoscopy for stent placement was effective in all our cases of difficult coledocholithiasis without any complications.

Civita Castellana (VT). Indagini archeologiche di emergenza nel suburbio di Falerii Veteres

In 2013 the works for the construction of the new sewerage network in Civita Castellana have allowed to find a stretch of ancient road paved in via Roma in the suburb of Falerii Veteres. The street was not yet known by archaeologists. It is characterized by a pavement with small lava stones. We know that the Roman conquest of 241 B.C. entailed the abandonment of the Faliscan city and the foundation elsewhere of a new town, called Falerii Novi. However this new discovery joins to other known archaeological evidence documenting the continuity of attendance after this date both the sanctuaries - frequented until the end of II - beginning of I century B.C.- and Falerii Veteres plateau, on which there arose a small Roman burial ground. These testimonies are certainly evidence of the frequenting of the site (although limited) even after the conquest by Rome. A subsequent earthy street with edges in tuff blocks has overlapped on the ancient street: it probably was made when the eastern access to Civita Castellana was built, under the pontificate of Pope Pius VI.