Ureteral Mass Research Articles

Xanthogranulomatous Ureteritis: A Diagnostic Challenge in a Patient with Bladder Cancer.

Xanthogranulomatous ureteritis is a very rare process characterized by the presence of foamy histiocytes in a background of chronic active inflammation affecting the ureteral wall. Herein, we describe a case of a 64-year-old man with bladder cancer affecting the left posterolateral wall of the bladder. Radiologically, there was a suspicion of multifocal involvement of the ureteral wall. The patient underwent a radical cystectomy with bilateral pelvic lymphadenectomy and a laparoscopic left nephroureterectomy. Histopathologic examination of the radical cystectomy revealed an invasive high-grade urothelial carcinoma. The wall of the left ureter was replaced by abundant foamy histocytes and a mixed inflammatory infiltrate with lymphocytes and plasma cells consistent with xanthogranulomatous ureteritis. In this report, we highlight the importance of awareness of this benign process when observing a ureteral mass in cancer patients.

A Case Report of a Rare Huge Ureteral Fibroepithelial Polyp: Challenges and Clinical Management

Ureteral fibroepithelial polyps (UFPs) are rare abnormality that may cause ureteral obstruction. Herein, we report a 35- year- old woman with flank pain, dysuria, frequency and transient total gross hematuria. A mass in the right ureter was reported on imaging and in endoscopic evaluation, small polypoid mass protruding from the right ureteral orifice in the bladder, and a huge ureteral mass originating from proximal ureter was observed. A right subcostal flank incision was done, a huge polypoid mass with a segment of ureteral was excised, and end-to-end anastomosis of the ureter was done. Histopathological examination showed a UFP without malignancy.

Ultrasound diagnosis and medical management of presumed segmental ureteritis in a cat

AbstractThis case report describes successful medical management of presumed segmental ureteritis in a 10‐year‐old, male, neutered, domestic shorthair cat. The cat presented for acute onset of lethargy, weight loss and a heart murmur. Abdominal palpation revealed renal asymmetry. Urinalysis and culture identified haematuria, struvite crystalluria and Proteus mirabilis infection. Abdominal ultrasound showed right hydronephrosis, right hydroureter and a focal right ureteral mass. Successful resolution of the right hydronephrosis, hydroureter and ureteral mass was achieved with antimicrobial therapy alone. Medical management may be an alternative, less invasive treatment to surgery for presumed feline segmental ureteritis.

Granulation tissue-type hemangioma of ureter: a highly misdiagnosed disease (a rare case report and literature review)

BackgroundUreteral granulation tissue hemangiomas are rare benign vascular lesions, and they may be clinically asymptomatic or present with massive or recurrent hematuria. Sometimes hemangiomas are difficult to distinguish from malignant ureteral tumors, and most ureteral hemangiomas are confirmed by postoperative pathological examination. This article aims to present a case of granulation tissue-type hemangioma of the ureter and briefly review the current literature on this condition.Case presentationA 30-year-old male patient presented with complaints of painless macroscopic hematuria for 2 months. Computerized tomography of the urinary system showed that the upper 1/3 of the right ureter was occupied, and then the possibility of tumor lesions was considered. The urine cytology showed occasional nuclear abnormalities and many light-stained crystals in urine. Because of suspicious radiological and cytological findings, the patient underwent the right ureteroscopy and the laparoscopic right ureteral mass resection. The postoperative pathological report showed that it was a mesenchymal tumor. The morphological and immunohistochemical staining was consistent with that of hemangioma, tending to granulation tissue hemangioma. After surgery, the patient was in a good state and recovered well at the last follow-up.ConclusionsUreteral granulation tissue hemangiomas are an easily misdiagnosed disease. Intermittent painless hematuria is an important characteristic of this disease. Therefore, we suggest that unnecessary radical surgery can be avoided when clinicians consider the possibility of benign ureteral tumors during the evaluation.

Metastatic Adenocarcinoma of Prostate posing as upper tract ureteral mass

Prostate cancer metastasis to the ureter is extremely rare because only 45 such cases have been reported worldwide in the last century. It accounts for 30% of ureteral metastasis. Neuroendocrine differentiation is approximately 1% of the entire primary prostate adenocarcinoma pathology. Metastatic prostate cancer may pose as upper tract urothelial carcinoma. Prostate may look normal on clinic-radiological examination in prostate cancer. Majority of such cases are managed with nephroureterectomy. Herein, we report a case of 62-year gentleman, who presented with refractory left flank pain with repeated imaging suggestive of neoplastic left ureteric stricture and normal prostate on clinic-radiological examinations. The case was later found with the diagnosis of metastatic prostate adenocarcinoma with neuroendocrine differentiation after left sided nephroureterectomy done for a provisional diagnosis of Upper Tract Urothelial Carcinoma (UTUC).

V02-10 ROBOTIC ASSISTED LAPAROSCOPIC EXCISION OF A FIBROEPITHELIAL POLYP OF THE URETER

You have accessJournal of UrologyMisc. Benign Disease & Transplant & Renovascular (V02)1 Sep 2021V02-10 ROBOTIC ASSISTED LAPAROSCOPIC EXCISION OF A FIBROEPITHELIAL POLYP OF THE URETER Zain Hyder, and Nathaniel Polnaszek Zain HyderZain Hyder More articles by this author , and Nathaniel PolnaszekNathaniel Polnaszek More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001979.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Fibroepithelial polyps of the urinary tract are rare tumors and are considered to be benign. We aim to present an exceedingly rare case of a large fibroepithelial polyp and describe its management. METHODS: The patient was a 32-year-old healthy female who presented with gross hematuria. Workup including CT IVP (computed tomography and intravenous pyelogram) demonstrated a large left mid ureteral mass. The patient underwent diagnostic ureteroscopy with biopsy of the mass followed by robotic excision of the mass and reconstruction of the ureter. RESULTS: The total operative time for the case was 185 minutes. In this time, diagnostic ureteroscopy was performed defining the large intramural mass with multiple sites of attachment. Frozen sections of the mass were obtained and demonstrated benign pathology. Robotic assisted laparoscopic exposure of the ureter was performed. A longitudinal ureterotomy was made and the mass was delivered out of the ureter. The mass measuring 7.1cm was entirely excised. The remaining ureter was tailored and reconstructed around an indwelling ureteral stent. The patient was discharged on post-operative day 1. A five month follow up with an Xray IVP showed a patent ureter without hydronephrosis. CONCLUSIONS: Fibroepithelial polyps are rare benign tumors. We demonstrated with an interesting case that robotic management of even very large masses is feasible with favorable post-operative outcomes. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e136-e136 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zain Hyder More articles by this author Nathaniel Polnaszek More articles by this author Expand All Advertisement Loading ...

Ureteral polyps protruding from the urethra

BackgroundUreteral fibro-epithelial polyp (UFP) is a rare benign ureteral tumor, and surgical removal of the polyps is still the preferred solution. Although many cases have reported polyps extending to the bladder, our case was the first to report a huge UFP that underwent endoscopic laser resection to highlight the urethra and cause severe end hematuria permanently.Case presentationIn 2019, a 37-year-old woman came to the hospital because of hematuria and a dark red extraurethral mass. CTU inspection showed: filling defect between the right ureter and the bladder at the entrance of the bladder. After ureteroscopy, it was found that the ureteral mass came out of the urethral orifice. Then, under the direct view of the ureteroscope, a Ho:YAG laser was used to remove the tumor by cutting off along the its base, and the patient was discharged 3 days after the operation.ConclusionUrethral polyps from the ureter should be considered in the differential diagnosis of urethral neoplasms. Ho:YAG laser resection under ureteroscopy is an effective option for treating UFP, but be careful of ureteral stricture after surgery.

A renal unit saving approach to IgG4 related periureteral mass mimicking malignant ureteral tumor

Immunoglobulin G4-related disease (IgG4-RD) is a rare disease with few cases mimicking ureteral tumour identified after the ablative surgery. We report a case of IgG4-RD that presented as a ureteral mass which was diagnosed prior to surgery and managed conservatively. A 63-year-old man presented with prior diagnosis of the right ureteric tumour but a radiological review suspected it could be something else. The patient underwent laparoscopic biopsy from the periureteric mass. Biopsy reported to be IgG-4 disease and managed conservatively. This case highlights the rare possibility of IgG4-disease mimicking ureter tumour and if diagnosed prior to extirpative surgery can result in salvage of the kidney.

Primary Ureteral Hemangiosarcoma in a dog

BackgroundPrimary ureteral neoplasia in dogs is extremely rare. To the best of the authors’ knowledge, this is the second documented case of a primary ureteral hemangiosarcoma. This case report describes the clinical and pathological findings of a primary distal ureteral hemangiosarcoma.Case presentationA 12-year-old spayed female goldendoodle was presented with a history of polyuria and weight loss. Abdominal radiographs revealed a large cranial abdominal mass. Abdominal ultrasound and computed tomography (CT) identified a left sided distal ureteral mass with secondary hydroureter and a left lateral hepatic mass with no evidence of connection or diffuse metastasis. A left ureteronephrectomy, partial cystectomy, and left lateral liver lobectomy were performed. Histopathology was consistent with primary ureteral hemangiosarcoma and a hepatocellular carcinoma. Adjunctive therapy including chemotherapy was discussed but declined.ConclusionDue to its rarity, the authors of this case presentation believe that ureteral hemangiosarcoma should be included as a differential diagnosis when evaluating a ureteral mass. With the unknown, and suspected poor prognosis, routine monitoring with adjunctive therapy should be considered.

Uroabdomen following rupture of a primary ureteral soft tissue sarcoma in a Labrador retriever

A seven-year-old, female neutered Labrador retriever presented for acute onset of lethargy and abdominal pain. Imaging showed the presence of an irregular mass in the left retroperitoneal space, extending from the caudal pole of the left kidney to the urinary bladder, and a moderate amount of peritoneal effusion. The excretory urography confirmed that the mass was originating from the ureter and the effusion was consistent with urine leakage. A left ureteronephrectomy was performed and histology revealed a primary soft tissue sarcoma of intermediate grade. This is the second description of ureteral soft tissue sarcoma and report of uroabdomen due to ureteral mass in veterinary literature.

Laparoscopic Nephroureterectomy in the Upper Urinary Tract Urothelial Carcinoma with Transvaginal Extraction

BACKGROUND: The upper urinary tract urothelial carcinoma (UTUC) is a rare urological malignancy. Laparoscopic nephroureterectomy (LNU) is one of the options for minimally invasive surgery for UTUC. It has similar oncological outcomes compared to open nephroureterectomy. One of the techniques developed for specimen extraction is the transvaginal route. Transvaginal specimen extraction has advantages in the reduced risk of complications, faster recovery time, and better end result.
 CASE PRESENTATION: A 37-year-old woman complained of intermittent pain in her right flank for the past 2 months, with significant weight loss. No other significant symptoms occurred. Her general condition was good with a Karnofsky Performance scale index is 90. In the right periumbilical area, there was a mobile, smooth mass palpated with the size of 10 × 12 cm. There was no tenderness. The patient underwent URS and biopsy of the right ureteral mass with pathological analysis resulting in UTUC. Then, the patient underwent laparoscopic radical nephroureterectomy.
 CONCLUSION: Although the surgical procedure was safe for the patient and more effective in terms of less morbidity, faster healing time, and better cosmetic appearance, transvaginal extraction of the kidney needs to be further studied, particularly relating to the little experience of this new technique.

“Bilateral Ureteral Diffuse Large B-Cell Lymphoma” from the Diagnosis to the Management: A Unique Case to be Reported and Review of Literature

We are reporting a rare case of bilateral ureteral Non-Hodgkin's lymphoma. A 55-year-old male patient was presented with bilateral loin pain, oliguria and high serum creatinine (8 mg/dl). Non contrast computed tomography revealed bilateral hydroureteronephrosis down to bilateral upper lumbar ureteral soft tissue masses. Drainage of the kidneys by fixation of bilateral indwelling ureteral stents was done. Evaluation of the patient by magnetic resonance imaging revealed bilateral enhancing proximal ureteral lesions. Bilateral diagnostic ureteroscopy revealed bilateral fleshy lesions in the upper lumbar ureter from which was retrieved. The biopsy was positive for poorly differentiated urothelial carcinoma. The patient was managed by right nephroureterectomy. Histopathological evaluation of the radical specimen was highly suspicious for lymphoma. Immunohistochemistry analysis confirmed the presence of diffuse large B-cell lymphoma. The patient received three cycles of multi-agent chemotherapy. Complete remission of the left ureteral lesion was confirmed by magnetic resonance imaging and diagnostic ureteroscopy.

Nephroblastoma in a black-tufted marmoset (Callithrix penicillata)

ABSTRACT: A renal nephroblastoma is described in a free-living black-tufted marmoset (Callithrix penicillata) in Central Brazil. The monkey was found dead and subjected to necropsy. Gross anatomic changes consisted of a ruptured left kidney, which was almost completely effaced by a white to yellow, partially encapsulated friable mass. The left ureter was distended due to obstruction by a red, spherical, 2mm in diameter friable mass. The urinary bladder was also distended. Histologically the renal and ureteral masses consisted of a triphasic embryonal neoplasm composed of embryonic epithelium forming glomeruli and tubules, polygonal blastemal cells, and a mesenchymal stroma. The embryonic epithelium exhibited rare nuclear immunoreactivity for WT-1, whereas blastemal cells exhibited robust cytoplasmic and rare nuclear immunoreactivity for WT-1; blastemal cells were also immunoreactive for vimentin. No immunoreactivity was detected for pan-cytokeratin (AE1/AE3), actin, and desmin. Morphological and immunohistochemical features of the present neoplasm are consistent with those described for renal nephroblastoma.

A ureteral mass presenting as deep vein thrombosis: a very rare presentation

A ureteral mass presenting as deep vein thrombosis: a very rare presentation

Ureteral obstruction secondary to an extraluminal myxoma in a cat

A 13-year-old female spayed domestic shorthair cat presented for evaluation of haematuria of one-month duration. Abdominal ultrasound identified a partially obstructed right kidney with mild pylectesia secondary to ureteroliths, as well as a discretely marginated hyperechoic and hyperattenuating mass along the proximal third of the right ureter. An abdominal exploration identified two ureteroliths that were treated with ureterotomy, and an extraluminal ureteral mass. Biopsy of the mass followed by histopathological examination confirmed the presence of an extraluminal myxoma. A telephone conversation 2 months postoperatively revealed that the cat showed resolution of clinical signs, and blood work showed no signs of obstruction. This is the first report of feline ureteral neoplasia, and the first extraluminal ureteral myxoma in the veterinary literature.

Ureteral Mass in a Patient with Localized Prostate Adenocarcinoma, A Rare Metastatic Location

Ureteral Mass in a Patient with Localized Prostate Adenocarcinoma, A Rare Metastatic Location

V6-12 TRANSVESCICOSCOPIC BLADDER CUFF EXCISION IN LAPAROSCOPIC NEPHROURETERECTOMY

You have accessJournal of UrologyMisc. GU Oncology and Transplant1 Apr 2017V6-12 TRANSVESCICOSCOPIC BLADDER CUFF EXCISION IN LAPAROSCOPIC NEPHROURETERECTOMY Young Eun Yoon, Sang Woon Kim, Hyung Ho Lee, Jang He Han, Seung Hwan Lee, Won Sik Ham, Koon Ho Rha, and Woong Kyu Han Young Eun YoonYoung Eun Yoon More articles by this author , Sang Woon KimSang Woon Kim More articles by this author , Hyung Ho LeeHyung Ho Lee More articles by this author , Jang He HanJang He Han More articles by this author , Seung Hwan LeeSeung Hwan Lee More articles by this author , Won Sik HamWon Sik Ham More articles by this author , Koon Ho RhaKoon Ho Rha More articles by this author , and Woong Kyu HanWoong Kyu Han More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1587AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To describe the management of the distal ureter during laparoscopic radical nephroureterectomy with the transvesical laparoscopic approach. METHODS The patient was placed in the modified lithotomy position with abducted thighs. The procedure started with cystoscopic examination of the bladder and ureteral orifices. After a small skin incision, a 5-mm-diameter trocar was introduced into the bladder dome. The anterior bladder wall was suspended to the abdominal wall to prevent the trocar from slipping out and 2 more 3-mm-diameter trocars were placed. The ureter was mobilized with hook electrocautery and dissected ureteral end was placed in extravesical space. Bladder was repaired with 4-0 vicryl. Then patient was placed in lateral position and conventional laparoscopic radical nephroureterectomy was performed. While dissection of distal ureter, the distal end of ureter was smoothly removed from perivesical space without any difficulty. RESULTS The patient was a 61-year-old female. The patient's CT scan showed right proximal ureteral mass and the result of previously performed ureteroscopic biopsy was transitional cell carcinoma, low grade. The operation time of transvesical bladder cuff excision was 50 minutes, and laparoscopic nephroureterectomy was performed for 120 minutes. Estimated blood loss of whole procedure was 300ml and there was no intraoperative or postoperative complication. Foley catheter was removed at 1 week. After 6 months postoperatively, there's no evidence of recurrence or metastasis. CONCLUSIONS Our initial experience with transvesicoscopic bladder cuff excision in laparoscopic radical nephroureterectomy demonstrated that the procedure is feasible and safe. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e682 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Young Eun Yoon More articles by this author Sang Woon Kim More articles by this author Hyung Ho Lee More articles by this author Jang He Han More articles by this author Seung Hwan Lee More articles by this author Won Sik Ham More articles by this author Koon Ho Rha More articles by this author Woong Kyu Han More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Primary ureteral leiomyosarcoma in a dog

A nearly 6-year-old female spayed Labrador Retriever was presented for acute abdominal pain and lethargy. The dog had no previous health concerns apart from occasional episodes of urinary incontinence in the 2 months prior to presentation. A retroperitoneal mass involving the right ureter was found during the investigations. Serum urea was mildly elevated, but the serum creatinine was within the normal range. No distant metastases were detected. A right ureteronephrectomy was performed. The ureteral mass was confirmed as a leiomyosarcoma and completely excised. The kidney was histologically normal. Unfortunately, during a routine 3-month postoperative assessment, a recurrent mass at the previous retroperitoneal surgical site was confirmed by biopsy to be a leiomyosarcoma. Courses of doxorubicin and chlorambucil were given, but failed to halt the progression of the recurrent mass. The dog was euthanised 5.5 months postoperatively because of poor quality of life. Ureteral leiomyosarcoma should be on the differential diagnosis list for a retroperitoneal mass, possibly causing severe abdominal pain with minor clinical signs associated with the urinary tract. This dog in this reported case of ureteral leiomyosarcoma had a short survival time, despite complete surgical excision and chemotherapy, because of local recurrence.

A case of pancreatic cancer complicated with IgG4 related ureteral tumor mass and AIP

A case of pancreatic cancer complicated with IgG4 related ureteral tumor mass and AIP

Antiangiogenic Agents, Chemotherapy, and the Treatment of Metastatic Transitional Cell Carcinoma

A 69-year-old man with a 100 pack-year history of smoking developed gross hematuria. His medical history included hypertension, a silent myocardial infarction, and a cerebrovascular accident complicated by seizures. Cystoscopy and biopsy showed a 4-cm mass at the right ureteral orifice positive for a high-grade papillary transitional cell carcinoma (TCC) with muscularis propria invasion (Fig 1). The computed tomography (CT)/positron emission tomography (PET) scan of the chest, abdomen, and pelvis showed hydronephrosis and hydroureter with marked cortical thinning and multiple bilateral PET-avid pulmonary nodules, with the largest in the left upper lung measuring 3.0 × 2.5 cm (Figs 2A, 3A), biopsy of which showed invasive high-grade urothelial carcinoma. The patient consented to join a clinical trial for metastatic TCC (USON [US Oncology Network study] 06040) involving treatment with gemcitabine, cisplatin, and sunitinib (GCS) 37.5 mg per day. Four days later, he experienced a 10-day hospitalization for acute pancreatitis and neutropenia. Sunitinib was discontinued, and he completed four additional cycles of GC. CT/PET showed that the right ureteral mass and all lung nodules had regressed or disappeared (Figs 2B, 3B). The largest remaining lung nodule at 1.4 cm showed no metabolic activity. He underwent a radical cystoprostatectomy and right nephroureterectomy, disclosing residual high-grade urothelial carcinoma infiltrating the full thickness of the ureteral wall. There was carcinoma in situ of the bladder, and 42 nodes were negative for cancer. The surgery was followed by a small, uncomplicated myocardial infarction. A scheduled left thoracotomy to remove the remaining nodule was cancelled. No additional chemotherapy was administered, and the patient remains free of recurrence 2 years from initiation of chemotherapy. The 1.4-cm nodule has calcified and remains stable and metabolically inactive. He has no sequelae of chemotherapy or surgery, with a creatinine level of 1.35 mg/dL.