Bone Neoplasms ; pathology ; Carcinoma, Neuroendocrine ; pathology ; Humans ; Osteosarcoma ; pathology ; Ureter ; pathology ; Ureteral Neoplasms ; pathology

We report a case of primary fibroepithelial polyps (FEPs) in the middle of both ureters in a patient with advanced gastric cancer and acute renal failure. Ureteral FEPs are rare benign lesions, and multiple, bilateral lesions are extremely rare. To our knowledge, this report is the seventh case of bilateral FEPs in the literature. Our case has clinical implications because FEPs should be considered as a cause of ureteral obstruction inducing acute renal failure in advanced gastric cancer.
Acute Kidney Injury/*etiology ; Aged ; Humans ; Male ; Neoplasms, Fibroepithelial/*pathology ; *Polyps/complications/pathology ; Stomach Neoplasms/*pathology ; Ureteral Neoplasms/*pathology ; Ureteral Obstruction/*pathology

We report a case of primary small cell carcinoma of the ureter with squamous cell and transitional cell carcinomatous components associated with ureteral stone, which is unique in that the patient has remained free of tumor recurrence for 36 months after the surgery without adjuvant chemotherapy or radiotherapy. A 60-yr-old man presented himself with a right flank pain. Computed tomography revealed an ill-defined mass and a stone in the lower one third of the right ureter, and hydronephroureterosis above the stone-impacted site. The patient underwent right nephroureterectomy and stone removal. Upon gross examination, a 3.8 x 1.8 x 1.2 cm white and partly yellow mass was noted in the anterior part of the ureter, resulting in indentation of the ureteral lumen on the posterior side. Light microscopic examination revealed that the mass was mainly composed of small cell carcinoma, and partly squamous cell and transitional cell carcinomatous components. The overlying ureteral mucosa and renal pelvis also contained multifocal dysplastic transitional epithelium and transitional cell carcinoma in situ. There was no vascular invasion, and the surgical margins were free of tumor. The small cell carcinomatous component was positive for chromogranin, neuron specific enolase, synaptophysin, and pancytokeratin but negative for high molecular-weight cytokeratin (K-903) by immunohistochemistry.
Carcinoma, Small Cell/*pathology ; Carcinoma, Transitional Cell/*pathology ; Case Report ; Human ; Male ; Middle Age ; Neoplasms, Squamous Cell/*pathology ; Tomography, X-Ray Computed ; Ureteral Calculi/*pathology ; Ureteral Neoplasms/*pathology

We report a case of primary fibroepithelial polyp of the right midureter. The patient was a 41-year-old-woman, complaining of right flank pain. An excretory urogram revealed right hydronephrosis and a filling defect of the the right midureter. The filling defect was produced by a large fibroepithelial polyp that was diagnosed and removed by ureteroscopy without open surgery. Large fibroepithelial ureteral polyps are relatively rare and ureteroscopy is the gold standard of diagnosis for ureteral filling defect.
Adult ; Case Report ; *Endoscopy ; Female ; Human ; Polyps/pathology/*surgery ; Ureter/pathology/*surgery ; Ureteral Neoplasms/pathology/*surgery ; Ureteroscopy

OBJECTIVETo study the clinicopathological characteristics of synchronous squamous cell carcinoma (SCC) of the renal pelvis and SCC of the ureter.

METHODSThe clinical data of two cases of synchronous SCC of the renal pelvis and SCC of the ureter were retrospectively reviewed and analyzed. In case 1, a 68-year-old man with hematuria for a month, imaging modalities revealed a right renal pelvis tumor and a right distal ureter tumor. The patient underwent nephroureterectomy and excision of the bladder cuff. Case 2, a 60-year-old man with the complaint of lower abdominal pain and left flank pain for a month, was diagnosed as left distal ureteral stone in another hospital. Ureterolithotomy was performed and a ureteral tumor was found at the lower site of the stone intraoperatively. The pathological report demonstrated SCC, and the patient was transferred to our hospital for further treatment. We found a left renal mass invading the left hemicolon during surgery, and nephroureterectomy was performed with a bladder cuff excision, left hemicolon resection, and also complete lymph node dissection. Neither of patients received adjuvant radiotherapy/chemotherapy.

RESULTSModerately differentiated SCC was reported in both of renal pelvis and ureter in case 1 and the tumor invaded the subepithelial connective tissue in the renal pelvis and superficial muscle in the ureter. In case 2, moderately differentiated SCC of the left renal pelvis with colon metastasis and poorly differentiated SCC of the ureter was reported with two retroperitoneal lymph node metastases. The two patients died from tumor recurrence and metastasis 5 and 6 months after the surgery, respectively.

CONCLUSIONSynchronous SCC of the renal pelvis and SCC of the ureter are rare and has high likeliness of early recurrence and metastasis, often with poor prognosis.

Aged ; Carcinoma, Squamous Cell ; complications ; pathology ; Humans ; Kidney Neoplasms ; complications ; pathology ; Kidney Pelvis ; pathology ; Male ; Middle Aged ; Ureteral Neoplasms ; complications ; pathology

Today, percutaneous nephrostomy and other related renal procedures are routine in most hospitals. This technique provides safe, rapid and direct access to the upper urinary tract for various diagnostic and therapeutic maneuvers. It has become a vital tool for the urologists who have been able to diagnose and treat ever more diverse pathologies of the urinary tract without open operation. Percutaneous nephrostomy was done on 276 cases with advanced malignancy and benign conditions during the period of March, 1985 to December, 1993. We were successful in using percutaneous nephrostomy as urinary diversion to ureteral obstruction or urinary leakage in 27l cases( 98% ). In four fifths of patients, obstruction was due to neoplasm, with the cervical cancer the leading cause. The post-nephrostomy complications were bleeding in 10 cases, enterocutaneous fistula in 4, perinephric abscess in 3 and sepsis in 1. Percutaneous nephrostomy proved to be ideally suited in condition of obstructive uropathy and urine leakage.
Abscess ; Hemorrhage ; Humans ; Intestinal Fistula ; Nephrostomy, Percutaneous* ; Pathology ; Pregnenolone Carbonitrile ; Sepsis ; Ureteral Obstruction ; Urinary Diversion ; Urinary Tract ; Uterine Cervical Neoplasms

Various laparoscopic nephroureterectomy techniques for urothelial carcinoma of the upper urinary tract have been developed to minimize postoperative discomfort and the necessity for a lengthy convalescence. We performed hand-assisted retroperitoneoscopic nephroureterectomy without hand-assisted device in 3 male patients with urothelial carcinoma of the distal ureter. Average operative time and estimated blood loss were 251 min (range 235 to 280) and 250 mL (range 200 to 300), respectively. Complication did not occur and conversion to open surgery was not necessary in all cases. Postoperative analgesic requirements were moderate and the time to regular diet intake averaged 3 days (range 2 to 4). None of the patients had a positive margin on the final pathologic specimen. At the average follow-up of 8.1 months, no regional recurrence, port-site metastasis, bladder recurrence, or distant metastasis were noted in any patient. We described our initial experience with the described technique, which obviates the need for midprocedural patient repositioning.
Aged ; Humans ; Laparoscopes ; Laparoscopy/*methods ; Male ; Middle Aged ; Nephrectomy/instrumentation/*methods ; Retroperitoneal Space/pathology/*surgery ; Treatment Outcome ; Ureter/pathology/*surgery ; Ureteral Neoplasms/pathology/*surgery

Objective: To explore the diagnostic values of HK2 testing and single-cell sequencing in the urothelial carcinoma (UC). Methods: The qualified urine specimens of 265 suspected UC patients or postoperative patients from the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China were collected. Both exfoliative cytology and HK2 testing were performed on clinically suspected UC or postoperative patients. The performance of diagnostic cytology and HK2, including consistency, sensitivity, specificity, positive predictive value and negative predictive value, was evaluated based on histopathological, clinical and imaging diagnosis. Isolated HK2 metabolically abnormal cells were subject to single-cell sequencing to verify the reliability of HK2 detection performance and to explore the molecular characteristics of UC. Results: The concordance rate of HK2 testing and cytology for detecting UC was 90.3% (102/113, Kappa=0.604). Compared with cytology, the sensitivity of HK2 was significantly higher (85.2% versus 75.6%, P=0.024). The detection sensitivity of combined HK2 testing and cytology was increased to 91.1%. HK2 testing was significantly more sensitive than cytology for diagnosing UC in the upper urinary tract (81.8% versus 65.5%, P=0.022). It was also more sensitive than cytology for diagnosing early-stage UC (82.6% versus 69.5%, P=0.375) and low-grade UC (69.6% versus 47.8%, P=0.125). Single-cell sequencing of the ten patients, whose samples were positive for HK2, demonstrated highly concordant copy number variations (CNVs) in tumor cells from the same UC patient, with heterogeneity in CNV profiles among different patients. Deletion of chromosome 8p was found in 3 of the 4 urine samples of renal pelvis UC. The 2 patients with benign lesions had no CNVs in all sequenced cells. Conclusions: The test for abnormal urinary glycolytic HK2 metabolism can assist urine cytology to improve the sensitivity of UC diagnosis, and it provides a novel and reliable approach for early detection of upper urinary tract UC and lower grade UC. Meanwhile, this study has preliminarily revealed the feasibility of single-cell sequencing in urinary samples, which is expected to improve the diagnostic specificity of HK2 testing.
Humans ; Urinary Bladder Neoplasms/diagnosis* ; Carcinoma, Transitional Cell/pathology* ; Reproducibility of Results ; DNA Copy Number Variations ; Kidney Neoplasms ; Ureteral Neoplasms ; Sensitivity and Specificity

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

OBJECTIVETo evaluate the prognostic factors of ureter transitional cell carcinoma (TCC).

METHODSBetween January 2001 and December 2005 133 TCC patients were treated. And the data was retrospectively analyzed.

RESULTSA mean age of the 133 patients was 68 years (range 43 - 87 years) at diagnosis. Altogether the non-invasive ureter TCC was found in 42 patients (31.6%) and the invasive ureter TCC in 91 patients (68.4%). Invasive ureter TCC growth was more common in distally located tumors (82.5%) compared to mid (62.5%) and proximal ureter (47.1%). Tumor stage, grade and location of the tumor were all correlated with disease specific survival in a univariate analysis. In a multivariate Cox analysis, tumor stage and grade were significantly associated with disease specific survival.

CONCLUSIONSMore invasive tumors are found in ureter than in bladder. Ureter cancer is more frequently found in the distal part. Distally located ureteral tumors are more likely invading into the muscular cell layers compared to proximally located tumors. Tumor stage and grade are still the more important prognostic factors for ureter TCC.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Analysis ; Ureteral Neoplasms ; pathology ; surgery