[Ureteral cancer occurred in megaureter]
Hiroshi Ushida1, Yoshikata Masuda, Shuichi Koizumi
1Department of Urology, Uji Tokushukai Hospital.
Nihon Hinyokika Gakkai Zasshi. the Japanese Journal of Urology
|December 17, 2008
Summary
A 58-year-old man presented with asymptomatic gross hematuria, diagnosed with ureteral cancer in a megaureter. Despite nephroureterectomy, bladder tumors recurred, necessitating radical cystectomy.
Area of Science:
- Urology
- Oncology
Background:
- Ureteral cancer is rare, often presenting with hematuria.
- Megaureter, a condition of ureteral dilation, can complicate diagnosis and treatment.
Observation:
- A 58-year-old man with asymptomatic gross hematuria was found to have a 2 cm papillary transitional cell carcinoma in a megaureter.
- Initial imaging revealed a dilated left ureter with a suspicious mass.
- Neither vesicoureteral reflux (VUR) nor ureterovesical junction (UVJ) stenosis were identified.
Findings:
- Pathological examination confirmed grade 2 papillary transitional cell carcinoma.
- Post-nephroureterectomy, multiple bladder tumors developed, indicating potential tumor seeding or multifocal disease.
- Recurrent bladder tumors required subsequent radical cystectomy and urinary diversion.
Implications:
- This case highlights the challenges in managing ureteral cancer within a megaureter.
- The recurrence pattern underscores the importance of vigilant surveillance for bladder tumors after upper tract urothelial carcinoma treatment.
- Radical cystectomy may be necessary for refractory or widespread bladder tumors following initial upper tract surgery.
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