ABSTRACT
ABSTRACT We describe the rare case of a 61-year-old female with right ureteropelvic junction (UPJ) obstruction caused by metastatic cholangiocarcinoma. Her past medical history was notable for cholangiocarcinoma treated with neoadjuvant chemoradiation and two orthotopic liver transplants six years earlier. Urology was consulted when she presented with flank pain and urinary tract infection. Diagnostic workup demonstrated right UPJ obstruction. She was managed acutely with percutaneous nephrostomy. She subsequently underwent robotic pyeloplasty and intrinsic obstruction of the UPJ was discovered. Histological examination revealed adenocarcinoma, consistent with systemic recurrence of the patient's known cholangiocarcinoma.
Subject(s)
Humans , Female , Pelvic Neoplasms/complications , Ureteral Neoplasms/complications , Ureteral Obstruction/etiology , Cholangiocarcinoma/complications , Pelvic Neoplasms/secondary , Ureteral Neoplasms/secondary , Ureteral Obstruction/pathology , Ureteral Obstruction/diagnostic imaging , Bile Duct Neoplasms/pathology , Urography , Tomography, X-Ray Computed , Cholangiocarcinoma/secondary , Hydronephrosis/etiology , Hydronephrosis/diagnostic imaging , Middle AgedABSTRACT
Context: The association of primary carcinoma of the ureter and lithiasis is extremely rare. We report a rare case of a primary carcinoma of the ureter with corariform calculus. Case Report: 60-year-old phaeodermal female, reported a history of right-side nephritic colic, hyperthermia and pyuria during the past 20 years andhad received treatment for urinary infections a number of times. The first clinical presentation was related to lithiasis and the tumor had not been shown up by excretory urography, cystoscopy or ultrasonography. Two months after the calculus had been eliminated, the patient began to have serious symptoms and a grade III transitional cell carcinoma of the ureter was discovered. Total nephroureterectomy and M.V.A.C. (Metrotrexate + Vinblastina + Doxo Rubicina + Cisplatina) chemotherapy were tried unsuccessfully. In this report we emphasize the diagnostic difficulty caused by the concomitant presence of the two pathologies. In our opinion, the rapid evolution in this case is directly related to the high grade of the tumor.
Subject(s)
Middle Aged , Humans , Female , Ureteral Neoplasms/complications , Carcinoma, Transitional Cell/complications , Urinary Calculi/complications , Ureteral Neoplasms/diagnosis , Ureteral Neoplasms/drug therapy , Carcinoma, Transitional Cell/diagnosis , Carcinoma, Transitional Cell/drug therapy , Fatal OutcomeABSTRACT
This study from India has envisaged a characterization of primary carcinomas of the ureter using a review of all available Indian literature over a period of 32 years. The character of the tumor in the Indian patients was clinically; pain, abdominal lump and haematuria with most neoplasms being single, situated in the ureteric pelvis and such neoplasms being squamous cell in type. The others were transitional cell carcinomas. Similar ureteric neoplasms reported from Western literature showed that the reporting authors gave the predominant complaint as haematuria alone, the neoplasm being usually multicentric and histologically mainly transitional cell carcinoma. Although a significant follow up could not be achieved among the 101 Indian patients, Western authors found that muscle invasion was the single most important histologically related point to endanger a good progress. The possible pathogenesis that could be thought of appears to be related to stasis.