Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2014 Jan;6(1):94-7.
doi: 10.4103/0974-7796.127035.

Isolated ureteric endometriosis presenting as a ureteric tumor

Raouf Seyam  1 , Alaa Mokhtar  1 , Waleed Al Taweel  1 , Ahmed Al Sayyah  2 , Asma Tulbah  2 , Waleed Al Khudair  1
Affiliations
Case Reports

Isolated ureteric endometriosis presenting as a ureteric tumor

Raouf Seyam et al. Urol Ann. 2014 Jan.

Abstract

A 32 year old lady presented with recurrent left flank pain for 4 weeks and chronic lower back pain. CT without contrast showed no stones and mild left hydronephrosis. CT of the spine suggested an inflammatory process at L5-S1 vertebra. The diagnosis was supported by a bone scan. Incidentally, the scan showed nonfunctioning left kidney. Diuretic renography confirmed poor perfusion and no excretion. A retrograde study showed narrowing of the ureter at the pelvic brim. Ureteroscopy showed a papillary mass in the lumen of the ureter from which multiple cold cup biopsies were taken. The pathology however was not conclusive. A robotic nephroureterectomy was carried out. Definitive pathology showed intrinsic endometriosis of the ureter. We conclude that endometriosis should be considered in the differential diagnosis of unexplained ureteric obstruction and ureteric lumen filling defects in young women.

Keywords: Endometriosis; tumor; ureter.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
Radiological investigations of the left renal unit. (a) An intravenous pyelogram showing no excretion from the left kidney. (b) A diuretic renogram showing no excretion of the left kidney. (c) A retrograde ureterogram showing filling defect of the left ureter at the pelvic brim. (d) A repeat diuretic renogram, 2 weeks after ureteric stent insertion, showing no improvement of excretion of the left kidney
Figure 2
Figure 2
Microscopic examination of the ureter at the level of endometriosis involvement. (a) Hematoxylin and Eosin staining showing endometriosis of the ureter underlying normal epithelium (arrow head). Endometrial stroma (thin arrows) and glands (thick arrow) are seen amidst ureteric musculosa (asterisk, ×50). (b) Ureteric musculosa (×200). (c) Ureteric epithelium (×200). (d) Hematoxylin and Eosin staining showing endometrial glands (thick arrow) and stroma (thin arrow, ×200). (e) Immunohistochemical staining for estrogen receptor positive in the endometrial glands (arrow, ×200). (f) Immunohistochemical staining for CD10 positive in the endometrial stroma (arrow, ×200)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Abrao MS, Dias JA, Jr, Bellelis P, Podgaec S, Bautzer CR, Gromatsky C. Endometriosis of the ureter and bladder are not associated diseases. Fertil Steril. 2009;91:1662–7. - PubMed
    1. Carmignani L, Vercellini P, Spinelli M, Fontana E, Frontino G, Fedele L. Pelvic endometriosis and hydroureteronephrosis. Fertil Steril. 2010;93:1741–4. - PubMed
    1. Smith IA, Cooper M. Management of ureteric endometriosis associated with hydronephrosis: An Australian case series of 13 patients. BMC Res Notes. 2010;3:45. - PMC - PubMed
    1. Clement PB. Kurman RJ. Blaustein's Pathology of the Female Genital Tract. 3rd ed. Vol. 17. New York: Springer-Verlag; 1987. Endometriosis, lesions of the secondary mullerian system, and pelvic mesothelial proliferations; pp. 516–59.
    1. Camanni M, Bonino L, Delpiano EM, Berchialla P, Migliaretti G, Revelli A, et al. Laparoscopic conservative management of ureteral endometriosis: A survey of eighty patients submitted to ureterolysis. Reprod Biol Endocrinol. 2009;7:109. - PMC - PubMed

Publication types