title: Papillary ureteral neoplasm of low malignant potential in the upper urinary tract: endoscopic treatment.
abstract: BACKGROUND
  Papillary ureteral neoplasm of low malignant potential (PUNLMP) is a rare diagnosis, and to our knowledge, has not yet been reported in the upper urinary tract. In this study, we aimed to present our experience in managing a very rare diagnosis, PUNLMP, in the upper urinary tract, with endoscopic treatment.
  
  
  METHODS
  Files of patients who received surgery between January 2007 and January 2013 for upper urinary tract tumors were reviewed and patients treated for PUNLMP in the upper urinary tract in 4 urology clinics were reviewed. Patients included in the study had at most 2 tumors in the ureter and had a pathology of PUNLMP.
  
  
  RESULTS
  The study included 11 patients with a mean age of 58.5 years. There were 9 men, and 2 women with a smoking rate of 81.8%. Nine patients (8 in the distal and 1 in the mid ureter) were managed using a semirigid ureteroscope. Two patients (1 with mid ureteral and 1 proximal) were treated using flexible ureteroscopy. The mean hospital stay was 1.56 days. Mean surgical time was 37.18 ± 7.14 minutes. The mean follow-up was 31.5 (range, 7-72) months. In the follow-ups, 3 patients had recurrences of 3, 2, and 4 mm in 9, 15, and 17 months, respectively.
  
  
  CONCLUSIONS
  For tumors with a low risk of progression and relatively low risk of recurrence, organ-sparing treatments should be the choice of preference. To support our initial findings, randomized controlled studies on larger cohorts should be designed.
authors.affiliation: Ministry of Health, Numune Teaching and Research Hospital, Department of Urology, Adana, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ercil
authors.affiliation: Ministry of Health, Numune Teaching and Research Hospital, Department of Urology, Adana, Turkey. Electronic address: cansener14@gmail.com.
authors.forename: Nevzat Can
authors.initials: NC
authors.lastname: Sener
authors.affiliation: Ministry of Health, Numune Teaching and Research Hospital, Department of Urology, Adana, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Altunkol
authors.affiliation: Ministry of Health, Numune Teaching and Research Hospital, Department of Pathology, Adana, Turkey.
authors.forename: Fulya
authors.initials: F
authors.lastname: Adamhasan
authors.affiliation: Department of Urology, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Yesil
authors.affiliation: Ministry of Health, Numune Teaching and Research Hospital, Department of Urology, Adana, Turkey.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Ortoglu
authors.affiliation: Ministry of Health, Cukurova Askim Tufekci State Hospital, Department of Urology, Adana, Turkey.
authors.forename: Ergun
authors.initials: E
authors.lastname: Alma
authors.affiliation: Ministry of Health, Haseki Teaching and Research Hospital, Department of Urology, Istanbul, Turkey.
authors.forename: Zafer Gokhan
authors.initials: ZG
authors.lastname: Gurbuz
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014516:Ureteral Neoplasms / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*
keywords: Carcinoma; Endoscopy; PUNLMP; Tumor; Ureter