Ureteral involvement by metastatic malignant disease

Intraureteral Metastasis From Colon Cancer Mimicking Primary Ureteral Carcinoma on FDG PET/CT

ABSTRACT

Hematogenous or lymphatic intraureteral metastasis from distant primary cancer is very rare. We present contrast-enhanced CT and FDG PET/CT findings in a case of intraureteral metastasis from colonic adenocarcinoma 3 years after colectomy. The intraureteral showed moderate enhancement on contrast-enhanced CT and increased FDG uptake on PET/CT mimicking a primary ureteral carcinoma. This case suggests that metastatic tumor of the ureter should be considered in the differential diagnosis in patients with hypermetabolic ureteral lesion and known malignancy.

Ureter metastasis from a primary cervical malignancy 3 years after initial treatment

Metastatic mucinous adenocarcinoma of the lower ureter is reported in a 55‐year‐old woman presenting with gross hematuria who was treated for cervical cancer 3 years prior.

Ureteral Metastasis of Colonic Adenocarcinoma with Enteroblastic Differentiation: A Rare Case to be Distinguished from Clear Cell Adenocarcinoma of the Urinary Tract

Adenocarcinomas with enteroblastic differentiation are rare clear cell tumors that are positive for enteroblastic markers. Enteroblastic differentiation is particularly uncommon in colorectal adenocarcinomas. Herein, we report a case of clear cell adenocarcinoma with enteroblastic differentiation in the sigmoid colon of a 38-year-old Japanese woman that metastasized to the lower left ureter. After neoadjuvant chemotherapy, the patient underwent low anterior resection. The tumor consisted of tubular, cribriform, and focal micropapillary proliferation of clear cells immunopositive for spalt-like transcription factor 4 (SALL4), glypican 3, and alpha-fetoprotein. Six months after the colonic resection, a tumor was found in the left lower ureter, which was resected. The ureteral tumor revealed clear cell adenocarcinoma, which was identical to the colonic tumor proliferating in the ureteral mucosa. Metastatic ureteral tumors are rare. We performed a literature search and found only 50 reported cases of ureteral metastases from colorectal cancer. Of these, only 10 metastatic tumors were identified in the ureteral mucosa. No case of ureteral metastasis of clear cell colorectal adenocarcinoma or colorectal adenocarcinoma with enteroblastic differentiation has been reported. Hence, it can be challenging to distinguish them from clear cell adenocarcinoma of the urinary tract and/or clear cell urothelial carcinoma. This paper discussed the differential diagnosis of these tumors and reviewed the clinicopathological features of colorectal carcinomas metastasizing to the ureter.

Diagnostic and Therapeutic Challenges in a Patient with Ureteral Metastases from a Triple Negative Breast Cancer

Metastatic ureteral tumors arising from a primary breast carcinoma are extremely rare. They present with hematuria and radiological findings compatible with obstructive ureteral phenomena. We present a case of an 87-year-old woman with a history of lymphoma and triple negative breast cancer (TNBC), during an emergency admission for peptic ulcer, developed macroscopic hematuria. Radiologic and endoscopic investigations revealed a remarkable stenosis at the lower segment of the right ureter, attributed to metastases from her breast carcinoma. We report this case with the aim to make both oncologists and urologists aware of this rare condition.

Extramedullary plasmacytoma of the ureter

INTRODUCTION

We report a rare case of an extramedullary plasmacytoma of the ureter.

CASE PRESENTATION

A 77-year-old man was referred to our hospital because of left hydronephrosis. Computed tomography showed a tumor in the left ureter, and tumor invasion into the periureteric fat was suspected. Urine cytology showed Eatypical cells whose nuclei were hyperchromatic (class IIIb). The left ureteral tumor was diagnosed as urothelial carcinoma (cT3N0M0) preoperatively. Subsequently, we performed laparoscopic radical nephroureterectomy with bladder cuff excision. The tumor was pathologically diagnosed as a plasmacytoma. Postoperative positron emission tomography did not reveal abnormal uptake, and bone marrow aspiration findings were normal. Consequently, the left ureter tumor was diagnosed as an extramedullary plasmacytoma of the ureter.

CONCLUSION

Extramedullary plasmacytoma commonly occurs in the upper respiratory tract or upper gastrointestinal tract. Extramedullary plasmacytoma of the ureter is rare. This is only the fourth reported case of extramedullary plasmacytoma of the ureter.

Ureteral metastasis in colorectal cancer: A case report and review of literature

Colorectal cancer (CRC) is a common clinical entity. A significant proportion of patients experience metastatic disease, typically in the form of lung and liver spread. We present the case of a CRC cancer patient with distant metastasis to the ureter, causing hydronephrosis. Ureteroscopy and biopsy confirmed the diagnosis and the patient was subsequently treated with percutaneous nephrostomy tube placement. Distant spread of CRC to the ureter represents an exceedingly rare phenomenon. This case highlights the importance of heightened index of suspicion for ureteral involvement in CRC when hydronephrosis is identified on staging or surveillance cross sectional imaging.