Hypernephroma and associated ureteral involvement

The propensity of a hypernephroma to invade the renal vein and even the inferior vena cava is widely known. However, in contrast to papillary carcinoma of the kidney, hypernephromas rarely involve the ureter. Review of the English literature reveals 42 reported cases of ureteral involvement. Most represented metastases as opposed to direct, contiguous extension which is extremely rare. C case of hypernephroma with contiguous castlike extension into the ureter without mucosal violation is presented. Mechanisms of ureteral involvement and implications regarding treatment of hypernephromas are discussed.