Sarcomatoid carcinoma of the urinary tract

Sarcomatoid urothelial carcinoma with chondrosarcomatous differentiation of the ureter: A case report and review of the literature

Sarcomatoid urothelial carcinoma of the urinary tract is associated with poor prognosis. The majority of sarcomatoid urothelial carcinomas are found in the urinary bladder, while a small minority have been shown to arise from the ureter. In the present case, a 72-year-old male patient was diagnosed with sarcomatoid urothelial carcinoma with chondrosarcomatous differentiation of the left ureter, and subsequently underwent nephroureterectomy and retroperitoneal lymph node dissection. Two lymph nodes from the renal hilum and one paraaortic lymph node were also found to have metastatic involvement; however, the patient refused to receive chemotherapy or radiotherapy and succumbed to bone and omentum metastasis at 6 months after the initial diagnosis. Sarcomatoid urothelial carcinoma of the ureter is uncommon. Even rarer is the presence of malignant heterologous elements, such as chondrosarcoma. The present study reports a rare case of sarcomatoid urothelial carcinoma with chondrosarcomatous differentiation of the ureter, as well as a review of the literature, in order to demonstrate the aggressive nature of this particular malignancy.

Sarcomatoid carcinoma of the ureter: a case report

We report a case of sarcomatoid carcinoma of the ureter in a 60-year-old woman who presented at our hospital with right flank pain. She had undergone total ovariectomy and radiation therapy for ovarian cancer at the age of 40 years. A diagnosis of ureteral tumor (cTsN0M0) led to radical right nephroureterectomy and partial cystectomy. Microscopic examination showed a tumor that contained areas of both sarcoma and transitional cell carcinoma. The carcinomatous tissues were blended into the sarcomatous areas and there was a transitional zone between the 2 components. Immunohistochemical examination showed that the spindle cells were positive for cytokeratin, so the final diagnosis was sarcomatoid carcinoma of the ureter. The patient has remained well without any evidence of recurrence for 5 months since the operation. There is no effective adjunctive therapy, so constant careful monitoring will be necessary. Sarcomatoid carcinoma of the ureter is a rare tumor and this is only the sixth case reported in Japan.