1/12. A micropapillary variant of transitional cell carcinoma arising in the ureter.A 79-year-old woman was evaluated for a ureteral stricture related to laser ablation of a tumor 6 months earlier at another institution. A ureteroscopic examination revealed an exophytic papillary tumor that was resected and examined histologically. The tumor was characterized by delicate papillae with thin stromal cores and numerous secondary micropapillae lined by small cuboidal to low columnar cells with uniform low-to-intermediate-grade nuclei, reminiscent of a serous borderline tumor of mullerian origin. The cell linings were 1 to 4 layers thick; mitotic figures were easily identified. The underlying stroma appeared edematous and contained scattered chronic inflammatory cells. No invasion was identified. After ascertaining that the patient had no known gynecologic neoplasm, the differential diagnoses considered included papillary nephrogenic adenoma, clear cell carcinoma, and the recently described entity of micropapillary transitional cell carcinoma. Because of the striking resemblance to serous carcinoma and the presence of significant mitotic activity, this case was felt to represent a case of micropapillary transitional cell carcinoma (world health organization grade 1 to 2) occurring in the ureter. To our knowledge, this tumor had some unique features (no areas of grade 3 nuclei or invasion) that have not been reported in tumors occurring in the urinary bladder. The transitional cell nature of the tumor cells was supported by the immunohistochemical staining pattern. The anatomic distribution of micropapillary transitional cell carcinoma is now expanded to include the ureter, and this tumor should be considered in the differential diagnosis for papillary lesions occurring in the ureter.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/12. The treatment of bilateral synchronous renal pelvic tumors with Bench surgery.Bilateral nephrectomy, renal perfusion and bench surgery have been used in the management of synchronous bilateral renal pelvic tumors in a 35-year-old man. The possibility of bilateral nephrectomy followed by hemodialysis and eventual transplantation was considered but was not done because we believe for the present time that the nature of the immune response and its importance in the pathogenesis of cancer are complicated and poorly defined. It is likely that immunosuppression may tip the balance toward the tumor. Bench surgery allowed us to perform radical resection of these urothelial tumors yet preserve enough renal tissue to sustain life. This patient is now enjoying an active life and has a blood urea nitrogen of 30 mg. per cent and a serum creatinine of 1.2 mg. per cent from the functioning third of the former right kidney.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/12. liposarcoma presenting as an intraluminal ureteral mass.An 86-year-old woman with a previous excision of a large retroperitoneal low-grade liposarcoma presented with a 4-month history of persistent left flank discomfort. Workup revealed left hydronephrosis secondary to obstruction, which was caused by a recurrent liposarcoma in the intraluminal ureter. She underwent a left nephroureterectomy for symptomatic palliation. Pathologic study revealed high-grade liposarcoma. Despite negative surgical margins, the tumor rapidly recurred, leading to death only 4 months after surgery. This case highlights the aggressive nature of liposarcoma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/12. carcinosarcoma of the ureter: a rare, pleomorphic, aggressive malignancy.AIM: To examine histological nature and clinical process of ureteral carcinosarcomas. methods: We report on a new case of carcinosarcoma of the ureter. The literature was reviewed and histological and clinical features were elucidated. RESULTS: Fourteen cases of ureteral carcinosarcomas have been reported. The nomenclature used for these tumors either in the pathology reports or in literature is confusing. In contrary to obscure tumor biology, prognosis was clearly bad as the majority of the patients died within 2 years after diagnosis. CONCLUSIONS: terminology confusion is due to the rarity of this entity and lack of its biology knowledge. patients present after the age of 60 with hematuria and obstruction. Nephroureterectomy is the only hope of cure but, due to tumor aggressiveness, recurrences occur almost always and prognosis is poor.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/12. Ureteral hemangioma: a clinical case report.The most greater part of the tumors ureteralis are of malignant nature, they are verified especially in the elderly patient and they have a preference for the distal third of the ureter. Of the tumors benign ureteral, the emangioma is a very rare vascular neoplasm. The symptoms aspecificis of presentation are: hematuria, colic type pains, hydronephrosis and bladder inflammation. Thanks to the refinement of the radiological techniques (urography, CTscan and eventually the ascending pyelography) and also to the simultaneous aid of the anatomopathologist, it is possible to obtain an accurate description of this pathology in a precocious stage in order to carry out a conservative approach. The peculiarity of the clinical case from us described depends on the fact that it deals with an occasional find, reaches our observation for appearance of severe hydronephrosis caused by ureteral stones, resolved him with methodic endoscopic.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/12. Possibility of spontaneous seeding of transitional cell carcinoma of the ureter in renal tubules: another mechanism of transitional cell carcinoma dissemination.Cancer cell seeding inside the urinary tract always has been considered one possible mechanism of the multicentric origin of transitional cell carcinoma (TCC). However, there is still no direct clinical evidence to prove that the natural seeding of TCC is a real event. To our knowledge, we report the first case of spontaneous seeding of TCC of the ureter in the renal tubules of a hydronephrotic kidney. The TCC nature of the intratubular tumor cells has been confirmed by the morphological appearance of them after hematoxylin and eosin staining and positive p53 immunohistochemical staining.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/12. Ureteric endometriosis: 3 case reports and a review of the literature.endometriosis involving the ureter is a relatively rare phenomenon but at least 121 cases have been reported previously. The 3 cases presented in this report emphasize some important facets of this condition: the lack of symptoms leading to late diagnosis, the presence of severe renal damage with very localized pelvic disease, how an incomplete initial operation may lead to further major difficulties, and the failure of medical therapy to halt its progress. The potentially lethal nature of ureteric endometriosis is stressed, and the different treatment modalities for patients of different ages and parity discussed. Surgical management, either conservative or radical, is suggested as the modality of choice, and where conservative operation is undertaken very careful continuing observation of renal function is a necessity.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/12. Urothelial and ovarian carcinomas of identical cell types: problems in interpretation. A report of three cases and review of the literature.Three women, 51-69 years of age with carcinomas of the urinary bladder or ureter, had ovarian tumors of identical cell types 2 to 7 years apart. In two cases the tumors were transitional-cell carcinomas and in the third case, signet-ring-cell carcinomas. It was difficult in the cases of transitional-cell carcinoma to determine whether the ovarian tumors were metastatic or independent primary tumors. Consideration of a variety of features of our two cases and of four similar cases reported in the literature led us to the conclusion that the ovarian tumors were probably metastatic in one case, probably primary in two cases, and of unknown nature in three cases, but some degree of doubt existed in all the cases. The signet-ring-cell tumor in the ovary had the typical features of a krukenberg tumor. Four of 11 women with signet-ring-cell carcinomas of the bladder have had ovarian metastases.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/12. Fibroepithelial polyp associated with congenital ureteral diverticulum: report of 2 cases.We report 2 cases of a single fibroepithelial polyp in conjunction with ureteral diverticula. Ureterorenoscopy is valuable in the identification of the benign nature of these lesions preoperatively to avert unnecessary nephroureterectomy. The etiology of fibroepithelial polyps remains unknown, although many theories have been proposed. Recent evidence has suggested that these lesions may be a developmental anomaly. Congenital ureteral diverticula also are thought to be of developmental origin. We hypothesize that fibroepithelial polyps and congenital diverticula of the ureter are part of a spectrum of the same developmental anomaly.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/12. Inverted papilloma of the ureter.We report a case of inverted papilloma of the ureter. To date it is the 12th case documented. The lesion was treated by conservative surgery; negative controls following the excision for 5 years represent a further proof of the benign nature of these tumors.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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