DOI: http://dx.doi.org/10.18203/2349-2902.isj20210023

Urothelial carcinoma in the ureteral stump of a nefrectomized patient by kidney exclusion: a case report

Tadeu J. F. L. Campos, Plinio H. F. Leandro, Lucas de O. Lima, André C. M. Lima, Lucas de A. Aquino, Marcos F. H. Rocha

Abstract


Urothelial carcinoma of the upper urinary tract is a rare and potentially aggressive disease. It rarely affects the ureter and is quite uncommon in the ureteral stump of a patient who has already undergone nephrectomy for benign disease. We, herein, describe a case of a male patient who underwent total left nephrectomy owning to renal exclusion. After three years, owning to an episode of hematuria, he was diagnosed with a urothelial tumor of the ureteral stump, and he underwent ureterectomy and excision of the bladder cuff. The involvement of the ureteral stump by urothelial tumor is an extremely rare event and is normally associated with poor prognosis owning to the delay in diagnosis inherent to atypical presentation. The most common symptom is hematuria. Pain is uncommon because of the absence of a renal unit and consequently, hydronephrosis. Although rare, we must remember the possibility of the appearance of primary tumors in the ureteral stump and maintain a high degree of diagnostic suspicion to avoid diagnosis in advanced stages.


Keywords


Simple nephrectomy, Ureteral tumor, Ureteral stump

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References


Munoz JJ, Ellison LM. Upper tract urothelial neoplasms: incidence and survival during the last 2 decades. J Urol. 2000;164(5):1523-5.

Dickman KG, Fritsche HM, Grollman AP, Thalmann GN, Catto J. Epidemiology and Risk Factors for Upper Urinary Urothelial Cancers. In: Shariat SF, Xylinas E. (eds) Upper Tract Urothelial Carcinoma. 2015, Springer, New York, NY, USA.

Segawa N, Kotake Y, Noumi H, Uchimoto S, Azuma H, Katsuoka Y, et al. [Ureteral tumor occurring from remaining stump: a case report]. Hinyokika Kiyo. 2006;52(7):565-7.

Kim YJ, Jeon SH, Huh JS, Chang SG. Long-term follow-up of ureteral stump tumors after nephrectomy for benign renal disease. Eur Urol 2004;46(6):748-52.

Smith JA Jr, Howards SS, Preminger GM. Hinman’s atlas of urologic surgery, 3th ed. Philadelphia, PA:Saunders. 2012.

El Khader K, Ouali M, Koutani A, Attya AI, Hachimi M, Lakrissa A. Carcinome à cellules transitionnelles du moignon urétéral après néphrectomie pour pyonéphrose. Prog Urol. 2001;11(2):304-6.

Inui M, Yamashita M, Taketa S, Takenaka I, Kakehi Y. Transitional cell carcinoma of the ureteral stump eight years after nephrectomy for benign disease. Int J Urol 2002;9(9):515-6.

Malek RS, Moghaddam A, Furlow WL, Greene LF. Symptomatic ureteral stumps. J Urol 1971;106(4):521-8

Flanigan RC. Urothelial tumors of the upper urinary tract. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Saunders Elsevier; PA: Philadelphia. 2007:1638-52.