Primary ureteral carcinoma. Experience in a general surgical service

Five cases (3M, 2F) of ureteral transitional cell carcinoma are reported. they have been observed in the last two years in a general surgical service. All the patients have been treated surgically. Gross hematuria was present in all the patients. Three cases had multicentric tumor sites. Three tumors were located in the distal ureter. Four cases showed a non functioning kidney at IVP. In two, because of obstruction, retrograde pyelography was unsuccessful. Ultrasound was able to demonstrate hydronephrosis. In the two cases submitted to angio-CT the spread of the tumor was correctly diagnosed. Frequency, etiology, clinical, diagnostic findings and surgical therapy as well have all been taken into account, based on the literature. Histopathologic aspects, grade and stage, are considered too. The authors emphasize the necessity to find and understand the cause of an unexplained hematuria, since ureteral carcinoma is not as rare as previously thought. Being grade and stage closely related to prognosis, the diagnostic delay must be reduced.