Contralateral renal cell carcinoma ureteric metastases can arise on tyrosine kinase adjuvant therapy and be effectively treated by endoscopic laser excision and ablation.

Sarah L Reid,Craig Mcilhenny,Gavin W A Lamb,Nikolas J Arestis

doi:10.1155/2014/359352

Abstract

Renal cell carcinoma (RCC) uncommonly metastasizes to the ureter and rarely to the contralateral ureter. We describe the presentation of 2 successive contralateral ureteric metastases from RCC in our institution. The first represents the only reported metachronous ureteric deposit on adjuvant sorafenib after laparoscopic radical nephrectomy for RCC. The other presented with a synchronous lesion after radiological work-up. Both lesions were treated with endoscopic excision and laser ablation with preservation of the renal unit and no local recurrence. We report these cases and discuss the literature.

Highlights

Ureteric metastasis from renal cell carcinoma (RCC) is a rare finding; ipsilateral lesions are the most reported in literature with over 50 reported to date
Ultrasound revealed a left renal mass; CT scan demonstrated in addition to the 56 mm left renal mass an 8 mm right pelviureteric junction stone in the lower pole moiety of a partial duplex kidney joining in the proximal third of the ureter (Figure 1)
Ureteroscopy confirmed a pedunculated vascular smooth solid lesion identical in appearance to the previous ureteric renal cell metastasis experienced in our unit

Summary

Introduction

Ureteric metastasis from renal cell carcinoma (RCC) is a rare finding; ipsilateral lesions are the most reported in literature with over 50 reported to date. We describe the presentation and management of two very different cases of contralateral ureteric metastases. The majority of literature describes surgical excision of these lesions. We outline a novel treatment of these rare lesions with endoscopic biopsy and laser ablation in order to preserve renal function and reduce morbidity

Case Reports

Findings

Discussion