[Primary transitional cell carcinoma in situ of the renal pelvis: a case report]

A 71-year-old female presented with left back pain at our hospital. She had had the same symptom about 1 year previously, but she had been presumed to have undergone stone passage because her symptom had disappeared. At this time a urogram, either excretory or retrograde, showed narrowing of each caliceal infundibulum and dilatation of each calyx in the left kidney, but otherwise normal findings. A cytology of left ureteral urine was class V, and cystoscopy revealed no abnormality. Under the diagnosis of left renal pelvic tumor she underwent nephroureterectomy with resection of a bladder cuff and retroperitoneal lymphadenectomy. The resected specimen had no gross tumor throughout the renal pelvis and ureter, but histological examination revealed transitional cell carcinoma in situ (grade 2) in most of the renal pelvis and infiltration of inflammatory cells in the submucosa. The ureter did not have any cancerous lesion, and no lymph node metastases was found. Four months postoperatively she is thought to have no evidence of disease with negative urinary cytology.