Percutaneous Management of Upper Urinary Tract Transitional Cell Carcinoma

Rhee, Jonathan; Jarrett, Thomas W.

doi:10.1002/9781444345148.ch28

Cited by 2 publications

(1 citation statement)

References 62 publications

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“…2 Although both antegrade intra-renal and intravesical installations of BCG have been described for the management of upper tract urothelial carcinoma, we have favoured the intravesical approach over percutaneous antegrade approach to minimize the risk of life-threatening BCGosis and risk of tumour seeding of the nephrostomy tract. [15][16][17][18] It is interesting to note that renal granulomas postintra-renal installation of BCG has been reported at a much higher rate of 25% when compared with intravesical installation (0.1%). 3,19 The fact that both of these patients developed renal granulomas may support the use of intravesical BCG for management of upper tract urothelial carcinoma.…”

Section: Discussionmentioning

confidence: 99%

BCG-Related Renal Granulomas Managed Conservatively

Al‐Qaoud¹,

Brimo²,

Aprikian³

et al. 2015

CUAJ

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Introduction: The aim of this case series is to present two cases of renal granulomas discovered incidentally post-intravesical Bacillus Calmette-Guerin (BCG) installations and were managed conservatively. Case reports: The first case is a 68-year-old man with bladder and right ureteral orifice carcinoma in situ. After transurethral resection of the right ureteral orifice and bladder tumours, he received 6 + 3 weekly intravesical installations of BCG and then 6 + 3 weekly intravesical installations of BCG with interferon alpha (IFN) in the presence of an indwelling ureteral stent since he had refused cystoprostatectomy. At the 18-month follow-up, his computed tomography scan showed two right renal masses. Biopsy demonstrated non-necrotizing granulomatosis. Serial follow-up with imaging studies showed complete resolution of these masses without antituberculous medications. The second case is a 74-year old man with left renal high-grade papillary urothelial carcinoma. After ureteral meatotomy and insertion of indwelling ureteral stents, he received 6 weekly intravesical installations of BCG followed by 3 weekly installations of BCG and IFN prior to the definitive management with laparoscopic left nephroureterectomy. Final pathology showed pT1 urothelial carcinoma and an incidental finding of BCG-related renal granulamotosis. The patient has been asymptomatic and did not require anti-tuberculous medications. Conclusions: While these two cases demonstrate the ability of intravesical BCG to reach the renal pelvis, patients with a history of intravesical BCG with incidental renal masses may benefit from renal biopsy. These renal granulomas may resolve without antituberculous medications.

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Section: Discussionmentioning

confidence: 99%

BCG-Related Renal Granulomas Managed Conservatively

Al‐Qaoud¹,

Brimo²,

Aprikian³

et al. 2015

CUAJ

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The Expanded Use of Percutaneous Resection for Upper Tract Urothelial Carcinoma: A 30-Year Comprehensive Experience

Motamedinia

Keheila

Leavitt

et al. 2016

Journal of Endourology

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Percutaneous management of UTUC allows for renal preservation in the majority of patients with resectable disease. Patients with HG tumors are more likely to experience recurrence, but are not at an increased risk of death. Intraluminal BCG and mitomycin continue to have a limited adjuvant role to resection. Recurrence may occur many years following initial resection and therefore prolonged surveillance is advised.

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Percutaneous Management of Upper Urinary Tract Transitional Cell Carcinoma

Cited by 2 publications

References 62 publications

BCG-Related Renal Granulomas Managed Conservatively

BCG-Related Renal Granulomas Managed Conservatively

The Expanded Use of Percutaneous Resection for Upper Tract Urothelial Carcinoma: A 30-Year Comprehensive Experience

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