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Benign tumors of the ureter

1957; Elsevier BV; Volume: 93; Issue: 3 Linguagem: Inglês

10.1016/0002-9610(57)90832-2

1879-1883

Joseph A. Lazarus, Friedrich Friedmann,

Urologic and reproductive health conditions

Benign tumors of the ureter are much less frequent than malignant ones. They involve the lower third of the ureter, as a rule. In most patients the tumors are solitary, of the papillomatous variety and sessile rather than pedunculated. Benign papillary ureteral tumors on rare occasions have been known to metastasize, yet they may produce implants. The main signs and symptoms of benign ureteral tumor are hematuria, pain in the loin and appearance of a mass in the loin owing to a hydronephrotic kidney. Superimposed renal infections are not unusual. A characteristic of this type of lesion is the discovery of an obstruction in the ureter which bleeds during manipulation of the catheter and which fails to show a shadow on the plain roentgen film or a scratch mark on the paraffin bulb. If one is able to surmount the obstruction and pass the catheter into the renal pelvis, the urine obtained there reveals no blood. Excretory pyelography is of little value in diagnosis. It is only through the careful interpretation of a good retrograde ureterogram that one can visualize the lesion. A positive ureterogram will disclose: (1) dilatation of the ureter below and above the site of obstruction; (2) a defect in the ureterogram at the site of the tumor, and (3) evidence of hydronephrosis. The discovery of a vesical tumor, particularly in the immediate area of a ureteric orifice, is suggestive of a tumor in the ureter or renal pelvis. The exact nature of the tumor, of course, cannot be established without histologie examination. Biopsies of ureteral tumors are not recommended. The treatment of choice in any type of ureteral tumor, if possible, is complete nephroureterectomy. If the tumor is in the lowermost portion of the ureter, a cuff of bladder should be included in the resection. A survey of the literature up to the middle of 1955 revealed a total of 128 cases of benign tumors of the ureters, including the one herein reported.