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The report describes a 75-year-old man with a left flank mass and nonfunctioning kidney whose imaging suggested calculus-associated hydronephrosis, but nephrectomy specimens revealed primary mucinous adenocarcinoma of the renal pelvis.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/a-slippery-diagnosis-primary-mucinous-adenocarcinoma-of-the-renal-pelvis-in-an-elderly-man/440199/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/a-slippery-diagnosis-primary-mucinous-adenocarcinoma-of-the-renal-pelvis-in-an-elderly-man/440199.png","ImageObject",300,407,{"name":42,"@type":43},"Alexandar","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why is primary mucinous adenocarcinoma of the kidney hard to identify before surgery?","Question",{"text":63,"@type":64},"It has atypical clinical/radiological features and resembles common urinary tract problems, and there is no widely accepted standard treatment protocol due to its rarity.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What led to the final diagnosis in the presented case?",{"text":68,"@type":64},"Postoperative histopathological examination of the radical nephrectomy specimen revealed primary mucinous adenocarcinoma involving the kidney.",{"name":70,"@type":61,"acceptedAnswer":71},"How did the diagnostic workup initially suggest a different condition?",{"text":72,"@type":64},"Imaging showed findings consistent with calculus-associated gross hydronephrosis at the pelvi-ureteric junction and additional calculi in the lower pole, which initially pointed away from 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Gupta, MD1,*, Shalini Radhakrishnan, MBBS2  , Deepa Sowkur Anandarama Adiga, MD2  ,  \nSadanand Poojary, MS, MCh, FMAS3, Vipin Tewani, MS3, and Chaithra GV, MD2  \nInternational Journal of Surgical Pathology 2026, Vol. 34(1) 174–178 © The Author(s) 2025  \nArticle reuse guidelines:  \n[sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI:](DOI: 10.1177/10668969251353425)[ 1](DOI: 10.1177/10668969251353425)[0.](DOI: 10.1177/10668969251353425)[11](DOI: 10.1177/10668969251353425)[77/](DOI: 10.1177/10668969251353425)[1](DOI: 10.1177/10668969251353425)[066896925](DOI: 10.1177/10668969251353425)[1](DOI: 10.1177/10668969251353425)[353425](DOI: 10.1177/10668969251353425)[ ](DOI: 10.1177/10668969251353425)[journals.sagepub.com/home/ijs](journals.sagepub.com/home/ijs)  \nAbstract  \nIntroduction. Primary mucinous adenocarcinoma of the kidney is an exceedingly uncommon malignancy. It comprises a minority of renal malignancies and presents notable diagnostic complexities owing to its atypical manifestation and resemblance in clinical features to common urinary tract conditions. Surgical intervention is the preferred treatment modality, although the prognosis remains bleak, with high rates of recurrence. A definitive diagnosis is established through postoperative histopathological examination. Patient Presentation. Here, we present a 75-year-old man who reported complaints of a mass in the left flank with clinical findings suggestive of a nonfunctioning left kidney. Initial diagnostic imaging suggested a pelvi-uretric junction calculus-associated gross hydronephrosis. However, a subsequent nephrectomy was performed, and the specimen received was subjected to histopathological analysis, which revealed the diagnosis to bea primary mucinous adenocarcinoma involving the kidney. Conclusion. This clinical observation highlights the diagnostic challenge and importance of considering rare entities in patients with vague clinical presentations. Histopathological evaluation is crucial in accurately diagnosing and appropriately managing such rare malignancies. This report contributes to the limited literature on this entity, emphasising the need for awareness among clinicians.  \nKeywords  \nadenocarcinoma, mucinous, tumor, renal pelvis, nephrectomy, histopathology  \nIntroduction  \nAdenocarcinomas originating in the renal pelvis constitute a minority, comprising \u003C1% of total malignancies in this region. These tumors can be subdivided into tubulovillous, mucinous, and papillary nonintestinal types.1 Ackerman LV was the first to document the occurrence of primary mucinous adenocarcinoma in the kidney in 1946 .2 This particular entity continues to be labeled as exceedingly uncommon, with under 100 patient reports described to date. The challenge lies in the preoperative identification of this condition, as it lacks distinctive symptoms and radiological signs. Furthermore, due to its rarity, there is no universally accepted standard treatment protocol.3 Moreover, understanding of primary mucinous adenocarcinoma in the kidney is significantly lacking, and the World Health Organisation has not acknowledged these tumors in the 2022 classification of renal tumors.4  \nHerein, we discuss comprehensively regarding an elderly man who came with complaints of a mass in the left flank and a nonfunctional left kidney who underwent radical left nephrectomy and, on subsequent histomorphological evaluation, was found to have primary mucinous adenocarcinoma  \nin the kidney. The diagnostic approach and therapeutic interventions adopted are meticulously detailed, and an extensive review of pertinent literature is included.  \nPatient Presentation  \nA 75-year-old man who had a chronic history of pelviuretric junction (PUJ) obstructive symptoms persisting for 2 years presented in the outpatient section of the  \n1Department of Pathology, ","cbCaihMnDYYlzWlO","https://ap.wps.com/l/cbCaihMnDYYlzWlO","pdf",1254291,"English","# Abstract\n# Introduction\n# Patient Presentation","[{\"question\":\"Why is primary mucinous adenocarcinoma of the kidney hard to identify before surgery?\",\"answer\":\"It has atypical clinical/radiological features and resembles common urinary tract problems, and there is no widely accepted standard treatment protocol due to its rarity.\"},{\"question\":\"What led to the final diagnosis in the presented case?\",\"answer\":\"Postoperative histopathological examination of the radical nephrectomy specimen revealed primary mucinous adenocarcinoma involving the kidney.\"},{\"question\":\"How did the diagnostic workup initially suggest a different condition?\",\"answer\":\"Imaging showed findings consistent with calculus-associated gross hydronephrosis at the pelvi-ureteric junction and additional calculi in the lower pole, which initially pointed away from malignancy.\"}]","A Slippery Diagnosis - Primary Mucinous Adenocarcinoma of the Renal Pelvis in an Elderly Man | PDF",1790691482,13]