Primary mucinous adenocarcinoma of the renal pelvis

Mucinous adenocarcinoma of the renal pelvis is a rare disease and preoperative diagnosis is difficult. It often presents with a mucinous-like discharge and is associated with prolonged irritation of inflammation or infection. We present a case in which the patient suffered from right flank dull pain with staghorn stone, and share our clinical experience of renal pelvis mucinous adenocarcinoma. The patient underwent right nephroureterectomy and pathological stage was pT1. He did not receive adjuvant chemotherapy. No recurrent tumor or metastasis was noted for about 1 year.     

Port site metastasis of primary adenocarcinoma of the renal pelvis after a laparoscopic nephrectomy: a case report

We report a case of port site metastasis of primary adenocarcinoma of the renal pelvis after a laparoscopic nephrectomy. A 76-year-old woman was admitted to our hospital with a complaint of anorexia, general malaise and left abdominal distension. Computed tomography revealed severe hydronephrosis in the left kidney. Laboratory examination revealed a high serum level of CA19-9 (155 U/ml). However, antegrade and retrograde pyelography revealed no filling defects and urine cytopathology for renal pelvis showed no malignancy. Thus, on the suspicion of a ureteropelvic junction stenosis, a laparoscopic nephrectomy was performed. There were some papillary tumors in the renal pelvis and a histopathological examination of the tumor revealed a papillary adenocarcinoma. Twelve months after nephrectomy, left iliopsoas muscle metastasis was found. Thus irradiation therapy with a total of 30 Gy was performed. However, 3 months later, the patient developed metastasis at the trocar site and the serum level of CA19-9 elevated to 6,720 U/ml. She died of multiple metastases from adenocarcinoma of the renal pelvis 4 months after port site metastasis.     

Primary adenocarcinoma of the renal pelvis with a pyeloduodenal fistula: a case report

A 62-year-old woman visited our hospital complaining of fever and right flank pain. On excretory pyelography the right kidney containing three renal stones was not visualized. Retrograde pyelography revealed an irregular filling defect in the right renal pelvis. Computed tomography revealed renal stones and a tumor mass in the right renal pelvis. From these findings, the pelvic tumor of the right kidney complicated by renal stones was diagnosed. Right nephrectomy was performed. Because a fistula between the renal pelvis and the second portion of the duodenum was found in the operation, partial resection of the duodenum was also performed. Pathological diagnosis was adenocarcinoma of the renal pelvis and pyeloduodenal fistula due to chronic pyelonephritis. Postoperative chemotherapy was not given. This is the first case report of adinocarcinoma of the renal pelvis coexisting with a pyeloduodenal fistula.     

Mucinous adenocarcinoma of the renal pelvis in the horseshoe kidney: a case report

A 41-year-old man with macroscopic hematuria and abdominal fullness was referred to our hospital. Computed tomography (CT) revealed a left renal pelvic tumor in the horseshoe kidney. We performed left heminephrectomy and ureterectomy. The pathological diagnosis was the mucinous adenocarcinoma in the renal pelvis. He received postoperative adjuvant chemotherapy (CAP therapy). He died of retroperitoneal recurrence 8 months postoperatively. In the literature we found 95 cases of primary adenocarcinoma in the renal pelvis including our case.     

Primary mucinous adenocarcinoma of renal pelvis with carcinoembryonic antigen production

We report a case of primary mucinous adenocarcinoma of the renal pelvis associated with carcinoembryonic antigen (CEA) production. A 48-year-old woman was incidentally found to have an elevated serum CEA level. A series of examinations revealed a fat-containing tumor in the left kidney and excluded tumors in other sites. Radical nephrectomy was performed, and the histopathologic examination revealed a mucinous adenocarcinoma that was strongly positive for CEA. Postoperatively, her serum CEA level gradually returned to the normal range, and she had had no recurrence by 9 months postoperatively.     

Mucinous adenocarcinoma probably arising in the renal pelvis and ureter: a case report

A patient with widely disseminated mucinous adenocarcinoma had polypoid tumors in the left renal pelvis and ureter. While no certain primary site was determined, either clinically or at postmortem examination, microscopic examination of the left renal pelvis and ureter revealed atypical glandular metaplasia adjacent to the tumors and made the upper urinary tract a likely site of origin for the adenocarcinoma.     

Primary papillary adenocarcinoma of renal pelvis: a case report and review of the literature

A rare case of primary papillary adenocarcinoma of the renal pelvis is reported. A 75-year-old man was introduced to our institute because of chance hematuria. He had no history of urolithiasis or urinary tract infection. Excretory urography showed a space taking lesion at the lower position of left renal pelvis with low function. Because of advanced stage with paraaortic lymphnode invasion, simple nephrectomy followed by irradiation and systemic chemotherapy with 5-FU was done. He died of pneumonia and acute heart failure after subtotal gastrectomy for peptic ulcer four months after the nephrectomy. Excised specimen revealed papillary adenocarcinoma of the renal pelvis without mucin production. This case was the 51st case reported in the literature. A short review of the disease is also reported.     

Primary adenocarcinoma of renal pelvis and ureter suspected as metastatic tumor: a case report

A 58-year-old man, who had undergone sigmoidectomy for sigmoid colon adenocarcinoma 3 years earlier, was referred to our clinic because of left ureteral tumor incidentally found by computed tomography (CT). Under the diagnosis of left ureteral carcinoma, retroperitoneoscopic left nephroureterectomy was performed. Pathological examination revealed adenocarcinoma of the left renal pelvis and ureter. Subtype of the adenocarcinoma was 'enteric type'. Five months later, urine cytology was positive and multiple non-papillary tumors were found on cystoscopy. By the transurethral resection of the tumors, bladder tumors appeared to be adenocarcinoma. Carefully considering the pathological findings and clinical course, we concluded that the tumor was not metastatic but primary adenocarcinoma followed by intravesical recurrence.     

Choriocarcinoma of the renal pelvis: a case report

A 68-year-old male presented to our hospital complaining of gross hematuria. Intravenous pyelography subsequently demonstrated a left non-visualized kidney, and he was admitted for further evaluation. Cystoscopy revealed a bladder tumor around the left ureteral orifice and retrograde pyelography showed a filling defect in the left renal pelvis. The urinary cytology from the left renal pelvis indicated class IV, and the microscopic findings of a bladder biopsy demonstrated grade 1 transitional cell carcinoma. We performed transurethral resection of bladder tumor (TUR-BT) followed by left nephroureterectomy with bladder cuff. The pathological diagnosis was high grade transitional cell carcinoma with choriocarcinomatous component. After the operation, the serum human chorionic gonadotropin-beta (hCG-beta) level was slightly elevated, and the combination chemotherapy with methotrexate, vinblastine and cisplatin (MVC) was administered. Although the serum hCG-beta level fell to 0.1 ng/ml, after two courses of MVC chemotherapy, bilateral pulmonary metastases appeared in the chest X-ray with increasing hCG-beta levels. Salvage chemotherapy with cisplatin, etoposide and bleomycin (PEB) was performed. After two courses of PEB chemotherapy, the serum hCG-beta level fell to within the normal range and all pulmonary metastases disappeared.     

Intra-abdominal mucinous adenocarcinoma of urachal origin: report of a case

Intra-abdominal mucinous cystic tumors can be difficult to diagnose preoperatively. We report a case of histologically diagnosed primary urachal adenocarcinoma: a rare type of bladder tumor. This case report is interesting for clinicians. The patient was an 86-year-old man who presented with acute abdominal pain. Computed tomography (CT) showed a large cystic mass with calcification, near the apex of the urinary bladder. Laparotomy revealed a large intra-abdominal cystic mass adherent to the anterior abdominal wall and superior to the urinary bladder. We performed laparoscopic-assisted resection and partial cystectomy. The cystic mass measured approximately 15 × 14 × 11 cm and contained mucinous material. Histological examination revealed that it extended to the muscle of the bladder wall and that its epithelium was composed of atypical cells with increased papillary morphology. The mucinous material was glycoprotein with degenerative fatty tissue, and calcification was recognized partly in the specimen. Thus, we comprehensively diagnosed a mucinous cystic adenocarcinoma of urachal origin.     

误诊为直肠癌的阑尾黏液腺癌1例

病例:病人,女,48岁。因"肛门坠胀1个月,肠镜检查发现直肠肿块1周"入院。纤维结肠镜检查提示,距齿线10 cm处直肠黏膜2 cm×2 cm隆起性病变,其余结肠未见异常。肠镜活检病理示"直肠黏膜中-重度不典型增生"。病人入院体检无异常,肛指检查直肠内未触及肿块,指套无血染;查血常     

Spontaneous rupture of the renal pelvis: a case report

A 63-year-old man admitted to our hospital with severe pain in his right flank on June 4, 1987. After admission, his pain increased progressively and he complained of tenderness from the right flank to the right lower quadrant. Computerized tomography and intravenous pyelography demonstrated spontaneous rupture of the right renal pelvis. A retrograde ureteral catheter was indwelling into the right renal pelvis. Because extravasation had disappeared on the retrograde pyelogram, the Catheter was withdrawn after 12 days. After removal of the ureteral catheter, he did not complain of pain. The 42 patients with spontaneous rupture of the renal pelvis reported in the Japanese literature and our one case were discussed.     

Sarcomatoid carcinoma of the renal pelvis: a case report

A 65-year-old man visited our hospital with the complaint of left hypochondrial pain. Since he had left giant hydronephrosis due to ureteral stone, we performed left nephrectomy. Unexpectedly, macroscopic examination of the resected kidney revealed multiple yellowish nodules located in the renal pelvis and calyces. Histopathologically the nodules consisted of two pattern of malignancy, transitional cell carcinoma and spindle sarcomatous tumor. Immunohistochemical examination showed that spindle cells were stained positive for cytokeratin, and the final diagnosis was sarcomatoid carcinoma of left renal pelvis. Postoperatively, the patient underwent two courses of adjuvant chemotherapy, but metastases to retroperitoneal lymph nodes were noted two months after operation. He died of the disease eight months postoperatively.     

A case of adenocarcinoma of the renal pelvis

A 28-year-old female had adenocarcinoma arising from the renal pelvis with ascites containing adenocarcinoma cells. The primary site was treated with radical nephrectomy, resection of the remnant ureter with a bladder cuff. Combination chemotherapy with cisplatin, doxorubicin, and cyclophosphamide (CAP) was performed as an adjuvant therapy. Approximately 3 years after the nephrectomy, she is currently alive with no clinical evidence of recurrence. CAP seems to have been effective in the treatment of the disease.