Transitional cell carcinoma

Case contributed by Mohamed Morsi
Diagnosis almost certain

Presentation

Right renal colic, renal dysfunction

Patient Data

Age: 85 years
Gender: Male
ct

Non-contrast study due to marked renal dysfunction.

Right moderate hydronephrosis is noted with dilated upper ureter which shows multiple soft tissue attenuations within the lumen and surrounding the most proximal part. Abrupt collapse of the distal third of the ureter, without any radiopaque ureteral filling defects. Features are suggestive of chronic obstruction by mass lesion, most likely transitional cell carcinoma.

Bilateral common iliac and external iliac nodal enlargement.

Left kidney is normal in size, shape and position with tiny non-obstructive calculi. No left hydronephrosis or hydroureter.

Two small stones are seen in the non-filled urinary bladder.

Markedly enlarged prostate.

Multiple lytic bone lesions of the vertebrae and ilia.

Multiple nodules of the lower lungs.

Impression:

Features are suspicious for right ureteric transitional cell carcinoma with nodal, bone and lung metastases.

Case Discussion

The appearance is suspicious for metastatic TCC of the ureter.

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