Transitional cell carcinoma of the ureter

Case contributed by Dr Ahmed Abdrabou

Presentation

Hematuria and left flank pain

Patient Data

Age: 80 years
Gender: Male

The left ureter is dilated down to a tight stricture at its distal segment. It shows areas of circumferential wall thickening at its mid segment as well as areas of intraluminal polypoidal masses distally. All these abnormal areas are enhancing in the postcontrast scan and there is also periureteric fat stranding. Associated moderate left hydronephrosis is noted.

Few left lateral para-aortic and common iliac lymphadenopathy are noted. Urinary bladder and renal pelvis were free.

Fatty liver, gallbladder stone and prostatic enlargement as other findings.

Case Discussion

Isolated involvement of the ureter with transitional cell carcinoma is much less frequent than of the urinary bladder or the renal pelvis. However, it is still the commonest cause of multiple ureteric masses. The patient underwent surgery and a diagnosis of T3N2 was made by pathology which was consistent with the radiological findings.

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