title: Spontaneous ureteral rupture during concurrent chemoradiotherapy in a woman with uterine cervical cancer.
abstract: Spontaneous rupture of the renal pelvis and ureter is associated with obstruction of the urinary collecting system, but is rarely caused by tumors. We describe our experience with a patient who had uterine cervical cancer with mild hydroureter in whom spontaneous ureteral rupture occurred during concurrent chemoradiotherapy. The patient was a 66-year-old woman with stage IIIB uterine cervical cancer and mild hydroureter who received concurrent chemoradiotherapy. The patient felt uncontrolled right-side abdominal pain caused by ureteral rupture after she was given hydration and an intravenous bolus injection of furosemide during the first week of chemoradiotherapy. Contrast-enhanced computed tomography was more useful than ultrasonography for diagnosis of the ureteral rupture. The ureteral rupture in our patient was attributed to a rapid rise in the pressure of the urinary collecting system caused by hydration and the bolus injection of furosemide. Placement of a double-J stent before starting concurrent chemoradiotherapy may help to prevent ureteral rupture in patients who have uterine cervical cancer with mild hydroureter.
authors.affiliation: Division of Gynecology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Shun-Ichi
authors.initials: S
authors.lastname: Ikeda
authors.affiliation: Division of Gynecology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Mitsuya
authors.initials: M
authors.lastname: Ishikawa
authors.affiliation: Division of Gynecology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Kato
keywords: Concurrent chemoradiotherapy; Contrast-enhanced computed tomography; Ureteral rupture; Uterine cervical cancer