Unilateral hydronephrosis resulting from intraluminal obstruction of the ureter by adenosquamous endometrioid carcinoma arising from disseminated endometriosis

Jimenez, Rafael E.; Tiguert, Rabi; Hurley, Patrick; An, Teisa; Grignon, David J.; Lawrence, Dwayne; Triest, Jeffrey A.

doi:10.1016/s0090-4295(00)00580-x

Cited by 35 publications

(21 citation statements)

References 13 publications

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“…Premalignant and malignant changes arising in a background of endometriosis have been well documented in the literature. Typically, a spectrum of morphologic changes is found in association with the malignant tumor, ranging from near normal glands to complex hyperplasia with atypia to frank malignancy [16]. Kapadia et al [9] reported a case of postmenopausal ureteral endometriosis with atypical adenomatous hyperplasia.…”

Section: Discussionmentioning

confidence: 99%

“…Kapadia et al [9] reported a case of postmenopausal ureteral endometriosis with atypical adenomatous hyperplasia. The incidence of malignant transformation has been documented in 0.3% to 0.8% of patients with ovarian endometriosis, whereas its occurrence in ureteral endometriosis is rare [16][17][18]. In most cases of premalignant and malignant changes in ureteral endometriosis, there is a history of prolonged unopposed estrogen treatment.…”

Section: Discussionmentioning

confidence: 99%

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Ureteral endometriosis: clinicopathological and immunohistochemical study of 7 cases

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ureteral endometriosis: clinicopathological and immunohistochemical study of 7 cases

et al. 2008

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“…Although the differential diagnosis of polypoid intraluminal ureteral tumors should also include polypoid transitional cell carcinoma, metastasis, and rare cases of malignancy or borderline malignancy arising from polypoid endometriosis, 6,8 it may be diffi cult to distinguish between benignity and malignancy on the basis of the radiological fi ndings. Maxson et al 16 reported that subtle abnormalities on high-volume intravenous urography were found in 15.9% of women with endometriosis who had no urological symptoms, hydroureter, or ureteral obstruction.…”

Section: Discussionmentioning

confidence: 99%

Polypoid endometriosis of the ureter mimicking fibroepithelial polyps

Marugami

Hirohashi²,

Kitano

et al. 2008

Radiat Med

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We present a case of polypoid endometriosis of the ureter that showed bilateral polypoid intraluminal masses in the lower part of the ureter mimicking ureteral fibroepithelial polyps, arising with a background of pelvic endometriosis and a history of gonadotropin releasing hormone (GnRH) therapy. Magnetic resonance imaging revealed the masses to have high signal intensity on T2-weighted imaging. The location and bilaterality of the polypoid intraluminal masses are considered useful points in the differential diagnosis of fibroepithelial polyps.

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“…Its malignant degeneration into endometrial carcinoma is extremely rare, though possible [4]. It mainly affects women of fertile age, even though cases of menopausal patients submitted to substitutive estrogenic hormone treatment have been described.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of ureteral obstruction from endometriosis: our experience with thirteen cases

et al. 2004

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Endometriosis is a biologically benign albeit aggressive pathology marked by high local recurrences. Ureteral involvement accounts for only a minority of cases (0.1-0.4%) with often non-specific symptoms at clinical presentation and difficult preoperative diagnosis. Thirteen cases of severe ureteral endometriosis (i.e. causing significant obstruction to the urinary flow) were observed and surgically treated, out of 17 ureteral units affected (three cases of bilateral involvement, one case of complete pyeloureteral duplicity). The initial symptomatology was acute and related to ureteral obstruction in eight cases, silent and non-specific in the other five; a presumptive diagnosis was made only for the seven patients (53.9%) with a positive medical history for pelvic (and in two cases also ureteral) endometriosis. Preoperative drainage of urine proved necessary for eight patients due to the complete functional exclusion of the excretory axis. One patient (7.7%) underwent nephrectomy due to renal atrophy. Segmental ureteral resection and termino-terminal anastomosis were performed in two patients, while seven patients underwent segmental ureterectomy and ureterocystoneostomy, with bladder psoas hitching in four cases and vesical flap according to Casati-Boari in one case. All three cases of bilateral involvement were treated by bilateral segmental ureterectomy and trans-uretero-uretero-cystoneostomy with bladder psoas hitching. Following histological examination, all patients were diagnosed with active ureteral endometriosis, which was found to be intrinsic in five cases (38.5%) and extrinsic in the other eight. One of the two patients that had undergone ureterectomy and termino-terminal anastomosis had to undergo ureteral resection and ureterocystoneostomy 22 months later due to relapsing endometriosis-induced stenosis. Conversely, no ureteral endometriosis relapses occurred in the remaining 12 patients within the mean follow-up time of 41.1 months (range 6-91). Ureteral endometriosis is marked by non-specific symptoms, making preoperative diagnosis often difficult. Therefore, an ultrasound or urographic examination of the urinary tract in case of pelvic endometriosis is absolutely essential. In our experience, terminal ureterectomy with ureterocystoneostomy has provided long-term favourable results as extended ureteral resection can be performed and continuity of the urinary tract can be restored without resorting to the distal pelvic ureter, which is often affected by the disease besides being more subject to relapses.

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Unilateral hydronephrosis resulting from intraluminal obstruction of the ureter by adenosquamous endometrioid carcinoma arising from disseminated endometriosis

Cited by 35 publications

References 13 publications

Ureteral endometriosis: clinicopathological and immunohistochemical study of 7 cases

Ureteral endometriosis: clinicopathological and immunohistochemical study of 7 cases

Polypoid endometriosis of the ureter mimicking fibroepithelial polyps

Surgical treatment of ureteral obstruction from endometriosis: our experience with thirteen cases

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