A rare case of metastatic ureteric malignancy from endometriosis

Abstract

A 61-year-old woman presented with left loin pain and was found to have a long standing left-sided hydronephrosis. CT IVU showed a 2.5 cm soft tissue in the region of the distal left ureter with marked proximal dilatation (Figures 1-3). Her urine cytology, flexible cystoscopy and renal function were normal. She underwent a left laparoscopic nephroureterectomy; histology revealed periureteric metastatic adenocarcinoma with clear margin. On immunohistochemistry, oestrogen receptor, CK7, BerEp4, and CEA were strongly expressed (Figures 4 and 5). She had a history of hysterectomy 20 years earlier for ovarian and fallopian tube endometriosis. It was found that adenocarcinoma had arisen within a focus of periureteric endometriosis persisting as hydronephrosis.