Related Experiment Video
Updated: Aug 8, 2026
Patient-derived Orthotopic Xenograft Models for Human Urothelial Cell Carcinoma and Colorectal Cancer Tumor Growth and Spontaneous Metastasis
Published on: May 12, 2019
[Transitional cell carcinoma of the ureter with inverted proliferation: a difficult case to make a differential
Hiroshi Hirata1, Ken Eguchi, Chietaka Ohmi
1Department of Urology, Yamaguchi University School of Medicine.
Insights
A rare inverted type transitional cell carcinoma of the ureter was diagnosed and successfully treated with nephroureterectomy. This case highlights diagnostic challenges and successful management of ureteral tumors.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Microscopic hematuria is a common symptom that can indicate various urinary tract conditions.
- Ureteral tumors are rare, with transitional cell carcinoma being the most common type.
- Inverted type transitional cell carcinoma is a rare variant with specific histological features.
Observation:
- A 59-year-old man presented with asymptomatic microscopic hematuria and a history of ureteral stone.
- Imaging revealed a filling defect in the left ureter; initial biopsy showed inflammatory tissue.
- Cytology results were equivocal (Class III vs. Class V), complicating the diagnosis.
Findings:
- Intraoperative frozen section revealed inverted type transitional cell carcinoma.
- Final histopathology confirmed grade 2 inverted type transitional cell carcinoma, measuring 5x5x5 mm.
- The patient underwent left nephroureterectomy and remained disease-free for 15 months post-operation.
Implications:
- This case underscores the importance of thorough evaluation for ureteral tumors, even with initial benign findings.
- Accurate pathological diagnosis, including frozen section, is crucial for appropriate surgical management of ureteral neoplasms.
- Successful treatment of inverted type transitional cell carcinoma of the ureter is achievable with radical surgery.
Abstract:
A 59-year-old man was admitted to our hospital in June 2001 for evaluation of an asymptomatic microscopic hematuria. One year prior to presentation, he had a spontaneous discharge of a left ureteral stone. Excretory urography and retrograde pyelography showed a filling defect in the middle portion of the left ureter. Cystoscopic examination did not reveal any abnormality, and urinary cytology was class I. Cold cup biopsy was performed under ureteroscopy, and pathology revealed inflammatory fibrovascular tissue but with no malignancy. Selective washing cytology was class III, whereas selective washing cytology done at the referring hospital was reported to be class V. Under a preoperative diagnosis of a left fibroepithelial ureteral polyp or a transitional cell carcinoma, left segmental ureterectomy was performed. The tumor was 5 x 5 x 5 mm in size, pedunculated, and smooth-surfaced. Intraoperative pathological examination of a frozen section showed an inverted type transitional cell carcinoma. Therefore, a left nephroureterectomy was performed, and the final histopathological examination confirmed an inverted type transitional cell carcinoma of grade 2. The patient is healthy and free of disease 15 months after operation. We also reviewed the current literature relating to transitional cell carcinomas of the ureter with inverted proliferation.
More Related Videos
Related Concept Videos
01:22Ureters
01:26Urinary Tract Infection I: Introduction
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
01:26Kidney Transplant II: Surgical Procedure
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography