Drogosis Achillefs Urological Surgeon Athens Greece

TUMORS OF THE RENAL PELVIS & URETERS

A tumor of the renal pelvis and ureter is a malignant tumor which usually originates in the cells forming the inner lining of the renal pelvis and ureter.

Incidence

  • Renal pelvis-ureter cancers are rare
  • They account for 1-2% of all urinary tract cancers
  • They usually develop during the 6th and 7th decade of life
  • They are more common in men than women; with a ratio of 3:1

Risk factors

A renal pelvis-ureter cancer has the same risk factors as bladder cancer:

  • Smoking
  • Occupational exposure to aromatic amines (8 times the risk)
  • Analgesic abuse, especially phenacetin
  • Chemotherapy with cyclophosphamide
  • Chronic inflammation
  • Balkan endemic nephropathy
  • Genetic factors

Symptoms

Ranked by frequency, they may manifest as follows:

  • Macroscopic hematuria: it is the most common symptom (60-70% of cases)
  • Colicky pain (30-40% of cases)
  • In advanced metastatic diseases: anorexia, loss of weight and bone pain

Diagnosis

The investigation process should always include:

  • Lab tests
  • CT or MRI scan of the urinary tract
  • Cystoscopy (to rule out bladder cancer)
  • Urine cytology examination
  • In case of doubt or with a solitary kidney, flexible ureteroscopy and biopsy specimens are required

Treatment

Surgical treatment.

The kidney is removed along with the ureter.

In special cases, renal pelvis-ureter cancer can be treated:

  • Endoscopically with ureteroscopy–laser-assisted resection
  • Partial surgical resection of the ureter