Ureteral tumor in an ectopic duplex system: a case report

Abstract

Introduction Ureteral ectopia is a rarely observed anomaly. It may be totally asymptomatic. An association with a duplex system is exceptional. Diagnostic and therapeutic approaches are challenging. Carcinologic surgery must consider the anatomic variant, mainly related to the ectopic site of the ureteral orifice. Observation We report a case of a ureteral urothelial carcinoma in a North African 52-year-old male patient, in a right duplex system. Radiological explorations concluded a non-functional upper right kidney. A suspect mass was observed in the lumbar part of the ureter of the right upper system. The meatus of the tumorous ureter ended in the right lobe of the prostate. A right hemi-nephro-ureterectomy was performed. A histological examination concluded a pT2G2 urothelial carcinoma. Conclusion Even if malignancy is rarely observed in ureteral ectopia, it should be evoked mainly in cases of hematuria with risk factors for urothelial tumors.

Management of Upper Tract Urothelial Carcinoma in a Double Collecting System Kidney

“…Follow-up was recorded for 2 years, and notably, the surrounding peri-distal ureteral tissue in the prostate remained intact. At the diagnostic URS 2 years later, there was no stump recurrence [28].…”

“…However, few of these surgeries were primarily for diagnostic purposes rather than definitive treatment, at times when diagnostic URS was unavailable. Furthermore, these procedures were typically performed through an open approach and were reserved for selected cases where radical NU would have led to irreversible kidney failure or death [10,11,13,16,21,25,28]. To the best of our knowledge, this is the first published robotic hemi-NU aimed at preserving renal function in a patient for whom NU was not an absolute contraindication.…”

Ectopic insertion of a duplicated ureter into the prostatic urethra

“…La bilateralidad es infrecuente, afecta más el lado derecho. (5,6) Los uréteres ectópicos frecuentemente se asocian con otras anomalías congénitas, como displasia renal, la duplicación ureteral y la hipoplasia renal. (5) Cuando la IUE es a nivel de la uretra prostática, el uréter distal pasa a través de los tejidos prostáticos, y la hiperplasia prostática benigna o los procesos inflamatorios provocan compresión ureteral.…”