Cause of upper urinary-tract essential hematuria: Veno-caliceal fistula or contralateral coexistent upper-tract transitional-cell carcinoma? Case report.
A 65-year-old woman was admitted with intermittent gross hematuria of 6 months' duration without other significant urinary-tract symptoms. At bilateral ureterorenoscopy under general anesthesia, a connection from an upper calix to the main left renal vein through a small venous channel was apparent, but there was no evidence of bleeding. In the right upper calix, a bleeding small papillary lesion was seen and ablated with low-power thulium laser coagulation. The histologic examination revealed a grade 3 stage pT1 TCC. Where no definite bleeding is seen from a veno-caliceal fistulous opening at ureterorenoscopy, it is imperative to inspect the entire contralateral upper urinary tract to exclude other causes of bleeding.
Defidio
L
L
Department of Urology, Hospital Cristo Re, Rome, Italy. defidio@tin.it
De Dominicis
M
M
Patel
A
A
D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006417:Hematuria / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007670:Kidney Calices; D007674:Kidney Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D007680:Kidney Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017075:Laser Coagulation; D009392:Nephrectomy; D012082:Renal Veins; D014548:Urinary Fistula / Q000150:complications* / Q000175:diagnosis / Q000601:surgery