Metastatic renal adenocarcinoma to the ureteral stump in a hemophiliac

Abstract

A case of a delayed distal ureteral metastasis from a cortical renal adenocarcinoma in a hemophiliac is presented as an unusual but significant problem. The need for total ureterectomy with nephreetomy is discussed. The various metastatic pathways for this tumor are presented. It would seem that the proposed avenues are, a t present, only theoretical, and it might be reasonable to assume that any one or several of them may be the pathway in an individual case. Regardless of the mode of spread, we must be cognizant of the possibility of distal ureteral metastases long after nephrectomy. The diagnostic value of cystoscopy during active bleeding is emphasized. With the use of coordinated efforts on the part of hematology, general medicine, and surgery, such instrumentation and quite radical operations can be and are being carried out successfully in hemophilia.

Malignancy in patients with haemophilia: a review of the literature

“…Unless found as part of a larger report, the literature review of solid tumours excluded specific references to any type of lymphoma or Kaposi sarcoma (KS), benign solid tumours or hepatocellular carcinoma (HCC). After these neoplasms were excluded, 159 cases of malignant solid tumours in persons with haemophilia were identified with an age range of 1.9–78 years [8,15,16,18,23,27–77]. A summary of the data can be found in Table 2 .…”

Residual Stump Metastasis from Renal Cell Carcinoma

“…It is questionable whether direct extension may be called metastasis or not, but Roller et al [23] reported a case of direct extension into the ureteral wall with no invasion into ureteral mucosa. Lymphatic spread is also imagined, but is suspicious because of the lack of con tinuity of lymphatic drainage of the kidney, ureter, and bladder [5,14], It is difficult to decide by which mechanism the métastasés in our case occurred, although the tumor protruded into the renal pel vis.…”