Abstract
Intracavitary bacillus Calmette-Guerin (BCG) therapy is considered an effective option for the treatment of noninvasive transitional cell carcinomas of the upper urinary tract. Few treatment related side effects have been reported to date. We report a case of a clinically symptomatic granulomatous renal mass after percutaneous BCG therapy for upper urinary tract transitional cell carcinoma in situ. A 51-year-old white man was successfully treated with 2, 6-week courses of intravesical BCG therapy for carcinoma in situ of the bladder 2 years previously. During followup visits endoscopic evaluation of the right upper urinary tract was performed because of a suspicious filling defect on excretory urography. No tumors were seen but repeated positive urine cytologies. Therefore, an 8Fr percutaneous nephrostomy tube was placed and by-weekly instillation of 81 mg. Connaught BCG in 250 ml. sterile saline was infused under gravity in 4 hours. Nephrostography was performed before every instillation to evaluate the proper position of the tube and absence of ureteral obstruction. No side effects were observed during the first 4 instillations.
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