| Abstract: | A case of a delayed distal ureteral metastasis from a cortical renal adenocarcinoma in a hemophiliac is presented as an unusual but significant problem. The need for total ureterectomy with nephrectomy is discussed. The various metastatic pathways for this tumor are presented. It would seem that the proposed avenues are, at present, only theoretical, and it might be reasonable to assume that any one or several of them may be the pathway in an individual case. Regardless of the mode of spread, we must be cognizant of the possibility of distal ureteral metastases long after nephrectomy. The diagnostic value of cystoscopy during active bleeding is emphasized. With the use of coordinated efforts on the part of hematology, general medicine, and surgery, such instrumentation and quite radical operations can be and are being carried out successfully in hemophilia. |
