Abstract
BackgroundUpper urinary tract urothelial carcinoma (UTUC) with multiple pathological types is extremely rare in the clinic, but the recurrence rate and mortality these patients are high. At present, there is no standard treatment for such cases.Case presentationWe reported a case of ureteral urothelial carcinoma with squamous cell carcinoma and sarcomatoid carcinoma differentiation and rapid ileal metastasis and reviewed the literature related to different pathological types of upper urinary tract tumours to explore the diagnosis, treatment and prognosis characteristics of the disease, enhance our understanding of its clinical manifestations and history of evolution and provide guidance for avoiding missed diagnosis and misdiagnosis.ConclusionThere is no standard treatment for urinary malignant tumours with multiple pathological types; radical surgery is considered a suitable choice. Chemotherapy, targeted drug therapy and immunotherapy may be beneficial to the survival of patients. In short, these patients have a high risk of recurrence and metastasis and a poor prognosis.
Highlights
Upper urinary tract urothelial carcinoma (UTUC) with multiple pathological types is extremely rare in the clinic, but the recurrence rate and mortality these patients are high
Patients with high-risk or locally advanced UTUC who receive cisplatin-based adjuvant chemotherapy have significant benefits in overall survival and disease-free survival compared with Radical nephroureterectomy (RNU) alone [9].the use of Neo Adjuvant Chemotherapy (NAC) or postoperative adjuvant chemotherapy for UTUC patients with multiple pathological types may be appropriate, which is worthy of further study
In summary, upper urinary tract urothelial carcinoma exhibits a variety of differentiation types and considerable variation
Summary
Upper urinary tract urothelial carcinoma exhibits a variety of differentiation types and considerable variation. In this case, renal pelvis and ureteral urothelial carcinoma with squamous cell carcinoma and sarcomatoid carcinoma differentiation and ileal metastasis showed rapid progression, a high degree of malignancy, a high risk of metastasis and a poor prognosis. Colour Doppler ultrasound, CT, PET/CT, MRU and urine exfoliative cytology are good auxiliary examinations for the diagnosis of this disease, which mainly depends on postoperative pathological biopsy and immunohistochemistry. Urinary malignant tumours with multiple pathological types have a high risk of recurrence and metastasis and a poor prognosis. Diagnosis and early treatment are the keys to improving the survival rate.
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