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Guadalajara, Mexico

Robles-Sainz L.R.,Servicio de Urologia | Zamora-Varela F.R.,Servicio de Urologia | Minakata-Ochoa F.,Servicio de Urologia | Alvarez-Alvarez A.,Servicio de Anatomia Patologia
Revista Mexicana de Urologia | Year: 2014

Approximately 5% of urothelial tumors occur in the kidney and ureter. Despite their homology with bladder urothelial neoplasms, these types of tumors present with certain characteristics that make them a diagnostic and therapeutic challenge. They have certain singularities, such as their association with phenacetin use and a strong association with upper urinary tract obstruction. Urothelial tumors present with a high genetic polymorphism that alters DNA expression and makes the host more susceptible to the environmental changes that may largely contribute to the development of urothelial tumors with different levels of aggressiveness and clinical behavior.The aim of this article was to report a case and carry out a review utilizing the Medline database for identifying urothelial tumor epidemiology, incidence, and risk factors.A 66-year-old man with a past history of smoking 40 cigarettes a day for 40 years presented with intermittent and painless total hematuria with coagulates over a period of several months. An ultrasound study revealed a solitary pedunculated 2. cm bladder tumor and a large capacity bladder. The patient underwent transurethral resection of the bladder and the histopathologic study reported a high-grade transitional cell tumor. Computed tomography urography of the upper urinary tract identified a solid tumor in both the renal pelvis and upper pole of the right kidney and a lesion in the renal pelvis of the left kidney, confirmed by excretory urography. Percutaneous resection of the left tumor and right nephroureterectomy were performed, with a histopathologic report of bilateral urothelial renal tumor, the left one low-grade and the 2 right ones high-grade. © 2014 Sociedad Mexicana de Urología. Source

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