Presentation
Hematuria and right flank pain
Patient Data
Partially-duplicated right ureters.
Circumferential wall thickening with heterogeneous enhancement of the lower pole right ureter down to its confluence with the other ureter before draining into the bladder; also noted is periureteric fat stranding.
Metastatic lymphadenopathies along the para-aortic, aortocaval, paracaval, and right iliac nodal chains.
Right renal lower pole mild hydronephrosis.
Urinary bladder and left kidney and right superior renal pelvis were unremarkable.
Case Discussion
Pathology proven case of right ureter transitional cell carcinoma.
The ureter is the least common location for transitional cell carcinoma (TCC) of the urinary tract, 2-3 times less common than TCC of the renal pelvis, and 100 times less common than transitional cell carcinoma of the bladder. It accounts for only 1% of all upper urinary tract malignancies 1.
The distal ureter is more frequently affected, presumably due to greater stasis 2,3:
- proximal third: 3%
- mid-third: 24%
- distal third: 73%
In 2-5% of patients, bilateral tumors are found 2,3.
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