Transitional cell carcinoma in ureteral stump after radical nephrectomy for renal cell carcinoma

In a seventy-five-year-old white man gross total painless hematuria developed one year after right radical nephrectomy for renal cell carcinoma. Results of physical examination, laboratory studies, intravenous pyelography, and cystoscopy were normal at that time. One year later, the patient had another episode of gross hematuria. Once again, physical examination, laboratory values, intravenous pyelogram, and cystogram were normal. A right retrograde ureterogram revealed a midureteral filling defect. Total ureterectomy and bladder cuff excision ensued. Pathologic examination revealed well-differentiated transitional cell carcinoma without muscle invasion.