Leiomyoma of the ureter

Abstract

A 57-year-old woman was referred following an acute episode of left-sided pyelonephritis associated with Klebsiella spp infection. After antibiotic treatment and resolution of the infection, the left flank pain continued and imaging revealed left hydronephrosis and hydroureter, with apparent obstruction on the left pelvic sidewall associated with the presence of a round lesion approximately 36 mm in diameter (Fig. 1). The left ovary appeared to be in close relation to the obstructing lesion, but separate. The right renal tract was normal. Her serum creatinine level was elevated at 102 μmol/L, but tumour markers were equivocal with normal results for carcinoembryonic antigen and CA-125, but an elevated level of CA19.9 (84 kU/L).The woman had undergone hysterectomy 8 years prior, for menorrhagia associated with a fundal leiomyoma (fibroid), and the uterus had been morcellated to effect delivery. No other abnormality had been observed at the time of hysterectomy, and the ovaries and fallopian tubes had been preserved. The patient had been completely well and asymptomatic in the intervening period. After the diagnosis of ureteric obstruction was made she wished to delay definitive surgery as her daughter was about to get married, so as an interim

Case series – Prioritizing bladder-sparing treatments in patients with urinary tract leiomyoma: A report of three cases and updated literature review

“…As with their lower tract counterparts, all previously reported cases of ureteral leiomyoma were treated surgically with either segmental ureterectomy or nephroureterectomy. 9,10 Unlike the bladder, complete endoscopic management of tumors in the ureter is limited given the smaller working channel of the ureter and the relatively thin muscle layer, the latter of which increases risk for perforation. These challenges likely account for the absence of endoscopic approaches to ureteral leiomyoma in the literature.…”

Primary leiomyoma of the ureter: a case report

“…According to our research, only 14 cases have been reported since the first report published by Leighton et al . in 1955 [ 2 – 15 ], making the present patient the 15th (Table 1 ). Apart from one patient being an infant, most of the patients were aged between 30 and 60 years (average age 41 years), including the present case, aged 51 years.…”

“…[ 14 ] 32 F Lt 112 × 70 × 15 Upper/middle Nephroureterectomy Englund et al . [ 15 ] 57 F Lt 36 Lower Tumor resection Present case 51 M Rt 20 × 10 Upper Nephroureterectomy UPJ: Ureteropelvic junction …”

Renal Pelvis Leiomyoma: A Novel Percutaneous Approach and Literature Revision

“…Ureteral leiomyomas are very rare benign neoplasms that usually present with symptoms of ureteral obstruction [3]. Since first described in 1955 [4], only 13 cases of leiomyoma of the ureter have been reported to date.…”

“…Since first described in 1955 [4], only 13 cases of leiomyoma of the ureter have been reported to date. Advances in ureteroscopy have enabled more conservative treatments of these tumors, allowing preservation of the kidney [3]. This report describes a patient with a renal pelvis leiomyoma who underwent kidney-sparing surgery using a percutaneous approach.…”