Abstract
Background: Historically, nephroureterectomy has been considered the treatment of choice for an upper urinary tract tumor. However, current literature supports a conservative endoscopic management in case of low-grade tumors and in patients in whom a radical surgery could represent an important morbidity. Therefore, an accurate diagnosis is essential to identify patients who may benefit from conservative treatment. Case report: A 75-year-old patient diagnosed with an upper urinary tract tumor of approximately 2 cm located in the upper right renal calyx. We performed an endoscopic ablation of the tumor with Holmium laser using a flexible 8.5 Fr ureteroscope. The surgery was uneventful and the patient was discharged the next day. The tumor biopsy reported a papillary urothelial neoplasm of low malignant potential. At 3 months, an endoscopic second-look was performed where no persistence or recurrence of the disease was evidenced. Conclusion: Conservative endoscopic management of upper urinary tract tumors is a suitable alternative for low-grade malignancy lesions, maintaining good oncological results and low complication rates. This procedure takes even more prominence in comorbid or single-kidney patients, in whom radical surgery represents a high surgical and medical risk.
Published Version
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