A Double Metachronous Ureter Metastasis following Curative Resection of Rectal Cancer

Abstract

A malignant ureteral obstruction is most often due to primary tumors of the ureter. However, it can occur secondary due to external tumor compression or metastatic infiltration. Distant metastases to the ureter are extremely rare. We present a case of a rare double distant metachronic metastasis to the right ureter as well as to the right renal pelvis in a 58-year-old female with a history of anterior resection for rectal cancer 2 years earlier. She presented with recurrent urinary tract infection and right hydronephrosis caused by an ureteral mass. The patient underwent a right nephroureterectomy via laparotomy. Two metastases of the rectal cancer in the ureteral mucosa were verified at histology. On account of the infiltration of the right ureteral orifice, a completion transurethral resection of the tumor was performed. A follow-up 3 and 6 months later showed no signs of tumor relapse and the patient was doing well. The differential diagnosis of malignant ureteral obstruction in patients with history of colorectal cancer should include the rare possibility of distant metastasis from the primary tumor.

Treatment efficacy and prognosis analysis in locally advanced or metastatic colorectal cancer patients with hydronephrosis

“…There is limited evidence or data on locally advanced or metastatic CRC patients with hydronephrosis receiving palliative care. Aghalarov et al (13) reported a case of postoperative recurrence of rectal cancer with urinary tract infection and right-sided hydronephrosis caused by a ureteral mass, who underwent laparoscopic right nephroureterectomy. The resected mass was pathologically confirmed to originate from rectal cancer.…”

Ureter Metastasis From Colorectal Cancer Revealed on 18F-FDG PET/CT

“…1 The ureter is an extremely rare location for colorectal metastases. [1][2][3][4][5][6][7][8][9][10] The metastases of the ureter are often associated with extensive metastasis at the time of diagnosis. 8 Although few cases of colon cancer metastasis to the ureter have been reported, our case has 2 significantly different aspects.…”

“…The most common metastatic sites of colorectal cancer are the lymph node, liver, lung, and bone 1 . The ureter is an extremely rare location for colorectal metastases 1–10 . The metastases of the ureter are often associated with extensive metastasis at the time of diagnosis 8 .…”