[Ureteral metastasis of renal parenchyma tumor]

Metastatic involvement of the ureter due to renal parenchyma neoplasia has been reported in a total of 53 cases in the literature, the described mechanisms for tumoral spread being: haematogenic, lymphatic, canalicular and direct. Time to appearance of metastasis is far from prompting agreement among the authors in terms of its synchronous or metachronous nature. The most frequently reported symptoms are total and painless haematuria, and obstructive uropathy: CAT, percutaneous nephrostomy (for locally advanced disease) and endoscopy, are the most frequently used diagnostic tools. The only available therapy is nephrouretectomy for a diagnosis synchronous with the primitive tumour, and uretectomy for metachronous emergence. This paper reports on a case of sarcomatoid renal tumour with ipsilateral synchronous involvement of the ureter, which caused an obstructive uropathy treated by nephrouretectomy.