Transitional cell carcinoma of ureteral stump after radical nephrectomy for renal cell carcinoma

Abstract

A 68-year-old male presented with microscopic hematuria during a routine checkup after undergoing a radical nephrectomy for renal cell carcinoma. Retrograde ureterography demonstrated a ureteral stump tumor. The ureteral stump was completely resected with a bladder cuff and histologic diagnosis was grade 2 to 3 transitional cell carcinoma of the ureteral stump. He is doing well and has been tumor-free for 2 years. The ureteral stump must be correctly evaluated using retrograde ureterography in any patient with a prior history of bladder cancer. Even if a patient had no history of ureterial cancer, whenever hematuria is present in the follow-up period after nephrectomy for renal cell carcinoma, a retrograde pyelogram should be performed.

Transitional cell carcinoma of ureteral stump after radical nephrectomy in a patient with a history of bladder carcinoma

“…To the best of our knowledge only 11 cases, including our own, have been reported in the literature [1][2][3][4][5][6][7][8][9][10] as hydronephrosis, urinary calculi, or renal tuberculosis may be implicated in developing primary ureteral carcinomas [11].…”

“…A possible explanation is that reflux might implant tumor cells into the ureteral stump [2]. Thus, a history of bladder cancer is considered a high risk factor in developing ureteral stump carcinomas [7].…”

“…It has been estimated that upper tract TCC occur in 2-4% of patients with urinary bladder cancer [7]. In some cases, ureteral stump carcinomas after nephrectomy were associated with prior bladder carcinomas [2].…”

Case Report: Primary Urothelial Carcinoma of Ureteral Stump Following Radical Nephrectomy for Renal Cell Carcinoma

“…In this situation suspicion is important and other diagnostic tool such as CT or retrograde ureterography can be helpful [9]. Nagatsuma, K. et al [1] suggested the ureteral stump must be correctly evaluated using retrograde ureterography in any patient with hematuria in the follow-up period after nephrectomy for RCC. In our case, the intravenous urography did not show any evidence of abnormality in right residual urinary tract.…”

“…Therefore, the remaining ureteral stump does not receive routine examination during follow-up. Nagatsuma, K. et al [1] reported a male patient presented with microscopic hematuria during a routine checkup after undergoing a radical nephrectomy for RCC. The histologic diagnosis of the patient was transitional carcinoma of the ureteral stump.…”