title: Gastric cancer recognized by metastasis to the ureter.
abstract: Although ureteral obstruction is rarely noted in patients with gastric cancer at an advanced stage or at autopsy, the condition caused by authentic ureteral metastasis of gastric cancer is extremely rare. We experienced a case of gastric cancer in a 51-year-old woman who showed bilateral ureteral metastasis. The patient initially complained of right flank pain, caused by right ureteral obstruction, and was referred to our hospital, where she underwent a right nephroureterectomy, with suspicion of primary ureteral neoplasm. Histopathological examination of the resected specimen showed that metastatic growth of adenocarcinoma in the ureteral wall had caused the obstruction, and the subsequent extensive search for the primary lesion revealed asymptomatic gastric cancer. Soon after the nephroureterectomy, the patient developed left hydronephrosis, possibly caused by left ureteral metastasis, and a left percutaneous nephrostomy was performed. She then received chemotherapeutic reagents. However, she finally developed peritoneal carcinomatosis, and died of the disease about 1 year after the onset of the disease. In this report, we also review true ureteral metastasis from the stomach, and discuss the clinicopathologic features.
authors: Department of Surgery, National Okura Hospital, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan.
authors: Yutaka
authors: Y
authors: Shimoyama
authors: Masakazu
authors: M
authors: Ohashi
authors: Naoko
authors: N
authors: Hashiguchi
authors: Masami
authors: M
authors: Ishihara
authors: Michio
authors: M
authors: Sakata
authors: Akihiko
authors: A
authors: Tamura
authors: Yutaka
authors: Y
authors: Asato
authors: Kenichi
authors: K
authors: Saitoh
authors: Miwako
authors: M
authors: Mukai