Transitional cell carcinoma (renal pelvis)
Discussion:
- ureteroscopy showed multiple blood clots in the ureter and renal pelvis; however, no obvious mass lesion was seen. Analysis of the blood collected from the right ureter and renal pelvis showed atypical malignant cells, suspicious of low grade malignancy. Later on, the patient underwent surgery which showed high grade urothelial malignancy.
- recommended ideal treatment of the TCC of the renal pelvis is surgical, consisting of a nephroureterectomy, taking not only the kidney but also the ureter and a cuff of the urinary bladder at the vesicoureteric junction, which was however, not followed in this case. 5-6 cm of the distal ureter was clearly visible on the 1st postoperative scan. Unfortunately, the patient developed mass/tumor (highly suggestive of recurrence) both at the right vesicoureteric junction as well as in the right nephrectomy bed 10 months later; however this recurrence was not biopsy proven due to the patient’s poor clinical condition. Suspicious gastric lesion was also not further evaluated. The patient died from the progressive disease a few months later.
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