A 70-yr-old man presented with painless gross hematuria. He underwent right nephrectomy for benign disease 9 yr ago. Computed tomography and cystoscopy showed a mass in the distal region of the right ureteral stump. He underwent right ureterectomy and bladder cuff resection. Pathological examination showed T1 and WHO grade 2 transitional cell carcinoma. At 6 months postoperatively, the patient is alive without any evidence of recurrence.
Aged ; Carcinoma, Transitional Cell/*diagnosis/pathology/surgery ; Cystoscopy ; Hematuria/urine ; Humans ; Kidney Diseases/*surgery ; Male ; Nephrectomy ; Tomography, X-Ray Computed ; Ureteral Neoplasms/*diagnosis/pathology/surgery

Adenocarcinoma ; diagnosis ; secondary ; surgery ; Aged ; Biopsy ; Cystoscopy ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Laparoscopy ; Male ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; surgery ; Radiography ; Transurethral Resection of Prostate ; methods ; Ureteral Neoplasms ; diagnosis ; secondary ; surgery ; Ureteroscopy ; Urethral Neoplasms ; diagnosis ; secondary ; surgery ; Urothelium ; pathology

12E7 Antigen ; Aged ; Antigens, CD ; metabolism ; Carcinoma, Transitional Cell ; pathology ; Carcinosarcoma ; pathology ; Cell Adhesion Molecules ; metabolism ; Cystectomy ; methods ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Nephrectomy ; Osteosarcoma ; metabolism ; pathology ; surgery ; Ureter ; surgery ; Ureteral Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Adenoma, Villous ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Lymphoma ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Myosins ; metabolism ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Rhabdomyosarcoma, Alveolar ; metabolism ; pathology ; surgery ; Ureteral Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

OBJECTIVETo analyse the clinicopathological features and discuss the diagnosis, therapy and prognosis of primary ureteral carcinoma.

METHODSOne hundred and seventy four cases of primary ureteral carcinoma diagnosed pathologically between January 1971 and July 2002 in our institution were followed up and retrospectively studied.

RESULTSThe incidence of primary ureteral carcinoma was increasing during the last 30 years. The mean age of occurrence was 63.7 years. The most useful methods of detecting tumors preoperatively were retrograde urogram, CT, magnetic resonance urography and ureteroscopy, with positive percentage of 87.8% (86/98), 96.0% (48/50), 95.8% (23/24), 87.0% (20/23) respectively. 131 (75.3%) cases underwent nephroureterectomy with a cuff of bladder. 171 (98.3%) cases were transitional cell carcinoma. T(a-2) and G(1, 2) tumors account for 70% of all respectively. The 5 year and 10 year survival rates were 53.1% (52/98) and 30.5% (18/59) respectively. The subsequent bladder cancer occurred in 38 cases (23.8%), and the subsequent contralateral ureteral carcinoma occurred in 6 cases (3.8%).

CONCLUSIONSThe prognosis of primary ureteral carcinoma is poor. Tumor stage and grade are both the prognostic factors. Precise preoperative diagnosis and more effective adjuvant therapy may improve the prognosis.

Adult ; Age of Onset ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Ureteral Neoplasms ; diagnosis ; epidemiology ; pathology ; surgery