Contralateral ureteral metastasis 4 years after radical nephrectomy
Hao-Jie Zhang1, Lu Sheng, Zhen-Wang Zhang
1Department of Urology, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai 200040, PR China.
International Journal of Surgery Case Reports
|January 31, 2012
Summary
Metastasis of renal cell carcinoma (RCC) to the contralateral ureter is exceptionally rare. This case highlights the importance of early detection and surgical management for improved survival in post-nephrectomy patients.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Metastasis of renal cell carcinoma (RCC) to the contralateral ureter is a rare clinical event.
- Only 50 cases of ureteral metastasis from RCC have been documented, with 6 occurring contralaterally.
- This report details a case of contralateral ureteral RCC metastasis occurring 4 years post-radical nephrectomy.
Purpose of the Study:
- To report a rare case of contralateral ureteral metastasis from renal cell carcinoma.
- To emphasize the significance of early recognition and management of such rare occurrences.
- To discuss diagnostic and prognostic factors in metastatic RCC to the ureter.
Main Methods:
- A 74-year-old male presented with painless hematuria.
- Computed tomography identified a distal ureteral tumor.
- Surgical resection of the affected ureteral segment with uretero-vesical anastomosis was performed.
Main Results:
- A 1.5 cm x 0.5 cm tumor was found in the contralateral distal ureter.
- A 3.5 cm segment of the ureter was resected and reconstructed.
- The patient's presentation included gross, painless hematuria.
Conclusions:
- Hematuria is a common sign of ureteral or bladder metastasis post-nephrectomy.
- The precise mechanism of contralateral ureteral metastasis remains unclear.
- Vimentin and cytokeratins may aid in differentiating metastatic RCC from transitional cell carcinoma.
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