title: [UNDIFFERENTIATED CARCINOMA OF THE URETER WITH FETAL CLINICAL COURSE: A CASE REPORT].
abstract: Undifferentiated carcinoma of ureter is rare neoplastic lesion, and the natural history of undifferentiated carcinoma of ureter has not been known well yet. We hereby presented an autopsy case of undifferentiated carcinoma of the ureter with rapid progression from the initial stage. A 62-year-old male visited the local urologist complaining of asymptomatic gross hematuria. Cystoscopy revealed the outflow of hematuria from the right ureteral orifice. Abdominal CT showed the right hydronephrosis with atrophic change of the renal parenchyma and the stenosis of upper ureter. He was referred to our hospital on suspicion of a right ureteral tumor. Magnetic resonance imaging and retrograde ureterography did not reveal a tumor in the right ureter. He complained of low back pain 4 months after the initial hematuria, and CT revealed the diffuse enlargement of the right kidney, swelling of the abdominal lymph nodes, and lung nodules. Renal biopsy was done, and only undifferentiated cells were revealed histopathologically without any specific findings to diagnose the primary organ. The tumor increased progressively, and he died about 6 months after the initial gross hematuria. Autopsy was performed, and urothelial carcinoma was found in the right ureter as the primary lesion. The ureteral tumor infiltrated to the right kidney, right adrenal gland, liver, duodenum, and pancreas with undifferentiation. Undifferentiated tumor cells were also found in distant metastatic lesion including the abdominal lymph nodes, left adrenal gland, liver, lung, pleura, and peritoneum.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hara
authors.forename: Tomonori
authors.initials: T
authors.lastname: Minagawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamagishi
authors.forename: Midori
authors.initials: M
authors.lastname: Ichino
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Ogawa
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kurizaki
authors.forename: Haruaki
authors.initials: H
authors.lastname: Kato
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishizuka
authors.forename: Masayuki
authors.initials: M
authors.lastname: Furuhata
authors.forename: Shiho
authors.initials: S
authors.lastname: Asaka
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishizawa
mesh_terms: D001344:Autopsy; D002277:Carcinoma / Q000150:complications / Q000628:therapy; D017809:Fatal Outcome; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014516:Ureteral Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy