Sarcomatoid carcinoma of the ureter: a case report

We report a case of sarcomatoid carcinoma of the ureter in a 60-year-old woman who presented at our hospital with right flank pain. She had undergone total ovariectomy and radiation therapy for ovarian cancer at the age of 40 years. A diagnosis of ureteral tumor (cTsN0M0) led to radical right nephroureterectomy and partial cystectomy. Microscopic examination showed a tumor that contained areas of both sarcoma and transitional cell carcinoma. The carcinomatous tissues were blended into the sarcomatous areas and there was a transitional zone between the 2 components. Immunohistochemical examination showed that the spindle cells were positive for cytokeratin, so the final diagnosis was sarcomatoid carcinoma of the ureter. The patient has remained well without any evidence of recurrence for 5 months since the operation. There is no effective adjunctive therapy, so constant careful monitoring will be necessary. Sarcomatoid carcinoma of the ureter is a rare tumor and this is only the sixth case reported in Japan.