First case of a primary osteosarcoma of the ureter: diagnostic findings, course of disease and treatment

Abstract

In October 2005, a 61-year-old patient was admitted with symptomatic right sided hydronephrosis. She was treated for breast cancer in 2003 with radical mastectomy and chemotherapy and for cervical carcinoma in 1983, which was cured by a Wertheim-Meigs operation and radiotherapy. An intravenous pyelogram was performed, which demonstrated occlusion of the right distal ureter (Figure 1). A subsequent ureteroscopy revealed a hard, round mass in the distal ureter that was not removable and occluded the lumen. Biopsies were taken and histopathology revealed a highly pleomorphic neoplasm composed of myxoid spindle cell sarcomatous elements and more closely packed spindle cells with malignant osteoid production. Distal ureteric resection with bladder-cuff and ureterocystoneostomy were performed (R0-resection). The patient made a good recovery from surgery and was discharged. Adjuvant chemotherapy was recommended but rejected by …