Primary tumor of the ureteral stump after a radical nephrectomy for renal cell carcinoma: case report and literature review

Abstract

We report a case of ureteral stump carcinoma following a radical nephrectomy for renal cell carcinoma. A 76-year-old man was diagnosed as having ascending colon cancer and a right renal carcinoma. He was treated with partial colon resection and radical nephrectomy without lymphadenectomy. The histology was renal cell carcinoma. Three years after that surgery, he complained of intermittent macrohematuria. Abdominal computed tomography (CT) suggested a solid mass in the pelvis. We then performed a biopsy with CT guidance. An epithelial tumor was suspected by immunohistochemistry. A total excision of ureter was then performed. The histology showed the features of urothelial carcinoma, G3, v(+), pT3. He received adjuvant chemotherapy with gemcitabine and cisplatin. He was free of disease for the following 11 months.

Keywords: Renal cell carcinoma; Ureteral stump carcinoma.

Fig. 1

Abdominal CT scan showed the presence of a 2.5 cm × 3.0 cm solid mass at the hilum of the right kidney (arrow). The signs of malignancy were not observed at the right ureter (circle)

Fig. 2

Pathological specimen of the renal cell carcinoma showing clear cell type, stage I (hematoxylin&eosin staining, × 400)

Fig. 3

Abdominal CT scan showed the presence of a 5.0 cm × 7.0 cm solid mass at the site of the iliac artery (arrow)

Fig. 4

Pathological specimen of the tumor biopsy showing lymphatic follicles (CK7 antigen, × 400)

Fig. 5

Microscopic examination of the right ureteral stump revealing high-grade urothelial carcinoma with focal interstitial infiltrates (hematoxylin&eosin staining, × 400)