Abstract
We report a case of urothelial carcinoma (UC) associated with a blind-ending bifid ureter. A 76-year-old man presented with asymptomatic, intermittent gross hematuria. Computed tomography revealed a mass in the left middle ureter at the level of the pelvic rim, which appeared to be the cause of hydronephrosis. A pouch of the ureter was also detected, and it was closely associated with the dilated main ureter along its entire length. Retroperitoneoscopic nephroureterectomy with open excision of the bladder cuff was performed. Pathological examination of the surgical specimen revealed two papillary UCs. The main tumor of dimension 30 × 15 × 15 mm was mainly located at the proximal end of the blind-ending branch and a solitary daughter tumor of dimension 5 × 5 × 5 mm was within the pouch. The main tumor was thought to originate from the blind-ending ureter and invade the adjacent main ureter, thereby causing the dilatations of the main and blind-ending bifid ureter. This is the second reported case of UC associated with a blind-ending bifid ureter. A long-term adverse effect of the blind-ending branch on the urothelial microenvironment may have important implications in the pathogenesis of malignancy.
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