[Upper urinary tract tumor and hydronephrosis to pelviureteric junction obstruction: a rare association]

The association between tumor of the urinary tract and hydronephrosis caused by a syndrome of the pyelo-ureteral junction is rare. Indeed, tumors of the upper urinary tract and hydronephrosis have generally a cause-effect relationship. This last is due, more often, to an obstruction caused by a tumor of the ureter or of the pyelo-ureteral junction. We report the case of a 66-year old patient with a history of smoking and right pyelonephritis, presenting with right lumbar pain intermittently evolving over several months without haematuria. Ultrasound showed a dilation of the pyelocaliceal cavities with major reduction of the corticomedullary index of the right kidney. Uroscan was in favor of cystic dysplasia of the right kidney as well as of right hydronephrosis associated with syndrome of pyelo-ureteral junction with budding intrarenal images leading to the suspicion of pyelic tumor. The assessment was completed by urinary cytology which was positive. Right laparoscopic nephroureterectomy was performed and pathologic examination confirmed the diagnosis of urothelial carcinoma of the upper urinary tract.