Pyeloscopy in Urothelial Tumors

Abstract

Intraoperative pyeloscopy was performed on 18 consecutive patients with indeterminate pelvic of caliceal filling defects, subsequently proved to be transitional cell carcinomas. After nephroureterectomy local tumor recurrence in the region of the renal fossa developed in 2 patients. Intraoperative pyeloscopy entails significant risks and the seeding of transitional cell carcinoma is possible.

Transitional cell carcinoma recurrence in the nephrostomy tract after percutaneous nephrolithotomy

“…However, Tomera et al reported two cases with local recurrence of transitional cell carcinoma in the renal pelvis, aft er intraoperative pyeloscopy followed by immediate nephroureterectomy to treat superfi cial, low grade tumors of the renal pelvis 3 . Although the literature contains a few publication regarding percutaneous tract seeding, our case suggested that endoscopic interventions might result in local recurrence in upper urinary tract TCC's despite low grade and small sized tumors.…”

“…Local tumor seeding of the nephrostomy tract has been theorized as a potential risk of percutaneous management of upper tract tumors and only a few cases of nephrostomy tract seeding have been reported 3 . In this paper, we report a case of nephrostomy tract tumor seeding aft er percutaneous nephrolithotomy (PCNL) in a patient with stone disease and incidental upper tract TCC.…”

Intracavitary Therapy of Noninvasive Transitional Cell Carcinomas of the Upper Urinary Tract

“…On the other hand, even though BCG infusion via a percutaneous nephrostomy tube is the more popular approach, this is not risk-free either, since it may cause retroperi- [42].…”

Conservative Management of Transitional Cell Carcinoma ofthe Kidney and Ureter

“…However, a variety of endourological approaches to renal pelvic and ureteral transitional cell carcinomas have been reported. Some investigators have suggested that conservative endourologic management in selected patients with upper tract urothelial tumors and a normal contralateral kidney may be appropriate (4 (6). One potential drawback of an endourologic approach may be the difficulty in adequately staging renal pelvic and ureteral tumors leading to understaging and inadequate treatment in some cases.…”