Renal Autotransplantation in Metachronous Solitary Contralateral Ureteral Metastasis from Renal Cell Carcinoma: A Case Report
Urology Journal,
Vol. 14 No. 6 (2017),
4 Aban 2017
,
Page 5073-5074
https://doi.org/10.22037/uj.v14i6.3795
Abstract
Ureteral metastasis of renal cell carcinoma (RCC) is rare and usually confined to the ipsilateral ureter. In literature, about 50 cases have been reported so far. Of these, only 14 metastasized metachronously to the contralateral ureter.A seventy-one-year-old man was hospitalized with recurrent painless severe haematuria. Seven years previously, he had undergone radical nephrectomy of the right kidney due to a clearcell renal cell carcinoma (cRCC), Fuhrman grad 2. Intravenous urography and a retrograde ureterogram revealed a filling defect (25 mm) in the left distal ureter, which we expected to be an urothelial carcinoma. Biopsy was not possible, due to ureteral stricture. Diagnostic workup revealed no other sites of metastasis. To preserve kidney function and quality of life we refrained
from performing nephroureterectomy and opted for an autotransplantation of the solitary left kidney with ureteral reimplantation in the bladder. We resected the ureter and histopathologicial examination showed a metastasis of cRCC, Fuhrman grade 2.
Postoperatively, the patient developed an acute postrenal failure, hence a nephrostomy and a bladder catherization were performed. After this, the patient improved significantly and the drains could be removed. Currently the patient is free of complaints. The residual and contralateral ureter is a potential metastatic site after RCC. Autotransplantation is an option for
surgical treatment.
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References
Tosco L, Van Poppel H, Frea B, Gregoraci G, Joniau S. Survival and impact of clinical prognostic factors in surgically treated metastatic renal cell carcinoma. Eur Urol.2013; 63:646–52.
Leblanc GA. Contralateral ureteral metastasis from renal adenocarcinoma. J Urol. 1961;86:316-8.
Mulira AE. Ureteric metastases from bilateral adenocarcinomas of the kidney. BJS. 1981;68:440.
Esrig D, Kanellos AW, Freeman JA, Stein JP, Kiyabu M, Ahlering TE. Metastatic renal cell carcinoma to the contralateral ureter. Urology. 1994; 44:278-81.
Chinegwundoh FI, French M, Warfield AR. Metastatic ureteral tumour. Urol Int. 1996; 56:55-6.
Zorn KC, Orvieto MA, Mikhail AA, et al.Solitary ureteral metastases of renal cell carcinoma. Urology. 2006; 68:428.
Zhang HJ, Sheng L, Zhang ZW, Sun ZQ, Qian WQ, Song JD. Contralateral ureteral metastasis 4 years after radical nephrectomy.International journal of surgery case reports. 2012; 3:37-8.
Krajewski W, Dembowski J, Kołodziej A, Małkiewicz B, Tupikowski K, Matuszewski M, et al. Urological complications after renal transplantation – a single centre experience. Cent European J Urol. 2016; 69: 306–11.
Toguri AG, Emtage JB, Jarzylo SV. Management of total ureteral loss after kidney transplantation. Can J Surg. 1983; 26:498-9.
Holmäng S, Johansson SL. Tumours of the ureter and renal pelvis treated with resection and renal autotransplantation: a study with up to 20 years of follow-up. BJU Int. 2005; 95:1201-5.
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