Adenocarcinoma ureterale primitivo di tipo intestinale. Caso clinico

Abstract

Intestinal type primitive ureteral adenocarcinoma is an uncommon neoplasm of the upper urinary tract, where the normal urothelium is replaced by an intestinal type glandular metaplastic epithelium. Our case concerns a 55-year-old man who 10 years ago had his left kidney and ureteral stump removed up to the junction with the iliac vessels due to a lumbar ureter filling defect. The ureter presented a 2 cm oedematous area with papillary vegetation. Histology revealed T1 adenocarcinoma with safe resection margin. Transurethral prostatectomy was performed and resectioning of a tumefaction of the left ostium, which proved to be an intestinal type of adenocarcinoma infiltrating the prostate. The patient underwent radical cystoprostatectomy with urinary diversion. The onset of primitive adenocarcinoma of the ureter may pass unnoticed in a chronically irritated urothelium. This case may be considered a multicentric, probably metachronous tumour and maximum surgical radicality is indicated as therapy.