Title: Poorly differentiated urothelial carcinoma of ureter presenting as Bulbar Palsy-An unusual presentation

Authors: Dr Girish V Hiregoudar, Dr Ashok Bhupali, Dr Archana Patil, Dr Shivkumar Donagaon, Dr Archana Shinde

 DOI: https://dx.doi.org/10.18535/jmscr/v8i6.74

Abstract

Urothelial neoplasms of the kidney and ureter (upper urinary tract) are uncommon, accounting for approximately 5% of all epithelial tumors of the urinary tract, with most urothelial tumors occurring in the urinary bladder1-8. Patients with upper tract urothelial neoplasms usually seek care because of gross hematuria (80%), flank pain (20%), and/or a palpable mass (10%).7,15,16. Here,we present a case of poorly differentiated  urothelial carcinoma  from upper ureter with a unique presentation  with bulbar palsy.

References

  1. Bloom NA, Vidone RA, Lytton B. Primary carcinoma of the ureter: a report of 102 new cases.J Urol.1970;103:590-598.
  2. Grabstald H, Whitmore WF, Melamed MR. Renal pelvic tumors.JAMA.1971;218:845-854.
  3. Wagle DG, Moore RH, Murphy GP. Primary carcinoma of the renal pelvis.Cancer.1974;33:1642-1648.
  4. Schmauz R, Cole P. Epidemiology of cancer of the renal pelvis and ureter.J Natl Cancer Inst.1974;52:1431-1434.
  5. Say CC, Hori JM. Transitional cell carcinoma of the renal pelvis: experience from 1940 to 1972 and literature review. J Urol.1974;112:438-442.
  6. Nocks BN, Heney NM, Daly JJ, et al. Transitional cell carcinoma of the renal pelvis.Urology.1982;14:472-477.
  7. Murphy WM, Beckwith JB, Farrow GM.Tumors of the Kidney, Bladder, and Related Urinary Structures . Washington, DC: Armed Forces Institute of Pathology; 1994: 313-320.Atlas of Tumor Pathology, 3rd Series, Fascicle 11.
  8. Greenlee RT, Hill-Harmon MB, Murray T, et al. Cancer statistics, 2001.CA Cancer J Clin.2001;51:15-36.
  9. Grace DA, Taylor WN, Taylor JN, et al. Carcinoma of the renal pelvis: a 15 year review.J Urol.1968;98:566-569.
  10. Huben RP, Mounzer AM, Murphy GP. Tumor grade and stage as prognostic variables in upper tract urothelial tumors. Cancer. 1988;62:2016-2020.
  11. Vahlensieck W, Sommerkamp H. Therapy and prognosis of carcinoma of the renal pelvis.Eur Urol.1989;16:286-290.
  12. Guinan P, Vogelzang NJ, Randazzo R. Renal pelvic cancer: a review of 611 patients treated in Illinois 1975-1985.Urology. 1992;40:393-399.
  13. Kim KH, Leiter E, Brendler H. Primary tumors of the ureter. J Urol.1972;107:955-958.
  14. Cummings KB. Nephroureterectomy: rationale in the management of transitional cell carcinoma of the upper urinary tract.Urol Clin North Am.1980;7:569-578.
  15. Melamed MR, Reuter VE. Pathology and staging of urothelial tumors of the kidney and ureter.Urol Clin North Am.1993;20:333-347.
  16. Bonsib SM. Pathology of the renal pelvis and ureter. In: Eble JN, ed.Tumors and Tumor-like Conditions of the Kidneys and Ureters.New York, NY: Churchill Livingstone; 1990:177-202.
  17. Bonsib SM, Eble JN. Renal pelvis and ureter. In: Bostwick DG, Eble JN, eds.Urologic Surgical Pathology.St Louis, MO: Mosby–Year Book; 1997:148-165.
  18. Epstein JI, Amin MB, Reuter VE. The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder.Am J Surg Pathol. 1998;22:1435-1448.
  19. Murphy DM, Zincke H, Furlow WL. Primary grade 1 transitional cell carcinoma of the renal pelvis and ureter. J Urol.1980;123:629-631.
  20. Murphy DM, Zincke H, Furlow WL. Management of high grade transitional cell cancer of the upper urinary tract.J Urol. 1981;125:25-29.
  21. Ozsahin M, Zouhair A, Villa S, et al. Prognostic factors in urothelial renal pelvis and ureter tumours: a multicentre rare cancer network study.Eur J Cancer.1999;35:738-743.
  22. Booth CM, Cameron KM, Pugh RCB. Urothelial carcinoma of the kidney and ureter.Br J Urol.1980;52:430-435.
  23. Charbit L, Gendreau MC, Mee S. Tumors of the upper urinary tract: 10 years of experience.J Urol.1991;146:1243- 1246.
  24. McLaughlin JK, Silverman DT, Hsing AW. Cigarette smoking and cancers of the renal pelvis and ureter.Cancer Res.1992;52:254-257.
  25. Batata MA, Whitmore WF, Hilaris BS, et al. Primary carcinoma of the ureter: a prognostic study.Cancer.1975;35:1626-1632.
  26. Guarnizo E, Pavlovich CP, Seiba M, et al. Ureteroscopic biopsy of upper tract urothelial carcinoma: improved diagnostic accuracy and histopathological considerations using a multi-biopsy approach.J Urol.2000;163:52-55.
  27. Streem SB, Pontes JE, Novick AC, et al. Ureteropyeloscopy in the evaluation of upper tract filling defects.J Urol.1981;126:383-385.

Corresponding Author

Dr Girish V Hiregoudar

Consultant Physician, Apple Saraswati Multispeciality Hospital, Kolhapur