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CASE REPORT |
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| Year : 2002 | Volume
: 18
| Issue : 2 | Page : 160-163 |
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Primary adenocarcinoma of renal pelvis & ureter: Report of three cases
Anup Kumar Kundu, Amita Giri, Sankar Prasad Kaviraj
Department of Surgery, Pathology & Radiology, North Bengal Medical College & Hospital, Darjeeling, India
Correspondence Address:
Anup Kumar Kundu
4, P.C. Sarkar Sarani, Hakimpara, Siliguri (W.B.) - 734 401
India
 Source of Support: None, Conflict of Interest: None  | Check |
 Abstract | | |
3 rare cases of primary adenocarcinoma of renal pelvis and ureter are illustrated here.
Keywords: Renal Pelvic Tumour; Adenocarcinoma; Ure-teric SOL; Haematuria
How to cite this article:
Kundu AK, Giri A, Kaviraj SP. Primary adenocarcinoma of renal pelvis & ureter: Report of three cases. Indian J Urol 2002;18:160-3 |
| Introduction | |  |
Primary adenocarcinoma of renal pelvis and ureter is an extremely rare tumour, representing less than 1 % of all renal tumours. [1],[2] Magumi et al [3] reported 92 nd case of primary adenocarcinoma of the renal pelvis. Most of the cases are reported from Japan. [3],[4],[5],[6] We had encountered 3 such cases which are described here.
| Results | | |
All the patients in our series had good postoperative recovery except the male diabetic one who had burst abdomen and was managed accordingly. Histopathology of all the cases showed adenocarcinoma of renal pelvis and ureter. All of them are in regular follow-up for last 38 months without any recurrence.
| Discussion | | |
The majority of the tumours in the renal pelvis and ureter (uro-epithelial tumours) are transitional cell carcinomas (TCC). Less common are squamous cell carcinomas (metaplastic, about 10%) and rarest are primary adenocarcinomas. [7] The rare primary adenocarcinoma of the renal pelvis and ureter is usually associated with calculi, long-term urinary obstruction and inflammation. [8],[9] These tumours are subdivided into i) tubulovillous, ii) mucinous, and iii) papillary non-intestinal categories. The first two groups representing intestinal adenocarcinoma constitute 93% of cases. [8] The mucinous adenocarcinoma have a better prognosis and occur in elder patients, but the papillary non-intestinal variety occurs in younger individuals and is not necessarily associated with infection. Most of the tumours are solitary. either in renal pelvis or in the ureter. But Lauritzen et al [10] observed multifocal tumours of both renal pelvis & ureter, in 4 out of 37 cases of their series. We have also the same experience.
The radiological investigations to be done are : ultrasonography (USG). intravenous (IVU) and retrograde urography, CT and if needed Doppler study. IVU shows the functional status of the affected kidney and combined with retrograde urography, usually shows a filling defect in the renal pelvis and ureter alongwith hydronephrosis and hydroureter (due to obstruction). USG shows a iso or hypoechoic soft tissue (solid) SOL at the renal pelvis extending into the upper end of ureter with or without hydronephrotic changes. CT is the investigation of choice and demonstrates the tumour with a total evaluation, e.g., appearance, extent, local spread and its effect on renal function. The final diagnosis is certainly by post-operative biopsy.
The treatment of these tumours is radical nephrectomy and total ureterectomy including the intravesical part. The prognosis depends on the grade and stage of the tumours. Again Lauritzen et al [10] state that adenocarcinoma and squamous cell carcinoma were high grade and late stage tumours in their series which is not in our case. Radio and chemotherapy had little role to play in these tumours. The initial diagnosis by ureteroscopy and brush biopsy may be helpful.
| References | | |
| 1. | Srinivas V. Renal tumour. In : Srinivas V (ed.). Urological oncology. Munnbai. India Printing House 1997: 2-19.  |
| 2. | Nepal Lec.unberri S. Pascual Piedrola JI, Arrondo Arrondo JL, Ipiens Azner A. Primary ureteral adenocarcinoma. ureteroscopic diagnosis. Arch Esp Urol 1992; 45: 29-31. |
| 3. | Megumi Y. Ohniori K. Nishimura K. Primary adenocarcinoma of the renal pelvis in young male: a case report. Acta Urol lap 1998; 44: 817-820. |
| 4. | Kim YI, Yoon DH. Lee SW et al. Multicentric papillary adenocarcinoma of the renal pelvis and ureter: Report of a case with ultrastructure study. Cancer 1998; 62: 2402. |
| 5. | Sakamoto N. Naito S, Kotoh S et al. Recurrence following surgery for primary renal pelvic and ureteric cancer - clinico pathologic analysis of distant metastasis. Jap J Urol 1992: 83: 658-663. |
| 6. | Kobayashi S. Ohniori M, Akaeda T. Ohmori H. Miyaji Y. Primary adenocarcinoma of renal pelvis : Report of two cases and brief review of literature. Acta Pathol Jap 1983: 33: 589-597. |
| 7. | Judith AW Webb. The renal collecting system: Uroepithelial tumours. In : Miere H. Cosgrove D. Dewbury K. Fart - ant P (eds.). Clinical ultrasound : Abdominal & General ultrasound. London. Churchill Livingstone 2001; 579. |
| 8. | Stein A. Sova Y. Lurie M et al. Adenocarcinoma of the renal pelvis: report of two cases, one with simultaneous transitional cell carcinoma of bladder. Urol hit 1988; 43: 299. |
| 9. | Spires SE, Banks ER. Cibull ML et al. Adenocarcinoma of renal pelvis. Arch Path Lab Med 1993; 117: 1156-1160. |
| 10. | Lauritzen AF. Kvist E. Bredisen J. Luke M. Primary carcinoma of the upper urinary tract. Acta Pathol Microbiol Scand 1987: 95: 710. |
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]
[Table - 1]
| This article has been cited by | | 1 |
Cytodiagnosis of mucinous cystadenocarcinoma of renal pelvis - A rare case report |
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| Bharathi, K. and Anuradha, S. and Khalique, A. | | International Journal of Pharma and Bio Sciences. 2012; 3(4): 136-141 | | [Pubmed] | | | 2 |
Mucinous adenocarcinoma of the renal pelvis with adenocarcinoma in situ of the ureter |
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| Raphael, V. and Sailo, S. and Bhuyan, A. and Phukan, M. | | Urology Annals. 2011; 3(3): 164-166 | | [Pubmed] | |
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