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Andrew Feifer1, Mona Alam El-Din, Atilla Omeroglu

  • 1Division of Urology and Department of Anatomical Pathology, McGill University Health Centre, Montréal, Que.

Canadian Urological Association Journal = Journal De L'Association Des Urologues Du Canada
|June 23, 2009
PubMed
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A rare case of asymptomatic ureteral endometrioma caused severe kidney damage. This benign tumor led to ureteral obstruction and renal atrophy, highlighting the need for early diagnosis and intervention.

Area of Science:

  • Urology
  • Gynecologic Oncology
  • Pathology

Background:

  • Ureteral obstruction can lead to significant renal damage.
  • Endometriomas are typically found in pelvic organs but can occur ectopically.
  • Asymptomatic presentations of ureteral masses are uncommon.

Purpose of the Study:

  • To report a unique case of a primary ureteral endometrioma.
  • To discuss the diagnostic challenges and management of this rare condition.
  • To emphasize the importance of early detection for renal preservation.

Main Methods:

  • Contrast-enhanced computed tomography (CT) for imaging.
  • Retrograde ureterogram to assess obstruction.
  • Ureteroscopy with biopsy for mass evaluation.

Related Experiment Videos

  • Laparoscopic nephrectomy and open ureteral dissection for treatment.
  • Histopathological analysis of the resected specimen.

    • Main Results:

    • Incidental finding of left hydronephrosis and right ureterohydronephrosis with renal atrophy on CT.
    • Complete ureteral obstruction identified 4 cm from the ureterovesical junction.
    • Ureteroscopy revealed a polypoid mass completely obstructing the ureteral lumen.
    • Biopsies showed inconclusive atypical urothelial changes.
    • Final pathology confirmed a benign obstructing endometrioma without invasion.

    Conclusions:

    • This is the first reported case of an asymptomatic primary ureteral endometrioma causing secondary renal atrophy.
    • Benign ureteral endometrioma can mimic malignant urothelial lesions.
    • Prompt diagnosis and treatment are crucial to prevent irreversible renal damage.