Plasmacytoid Urothelial Carcinoma of Ureter with Retroperitoneal Metastasis: A Case Report.

Content Provider	Europe PMC
Author	Jibril, Alexis Stevens, Andrew C.
Copyright Year	2018
Abstract	Patient: Male, 60Final Diagnosis: Plasmacytoid urothelial carcinoma of ureterSymptoms: Constipation • epigastric pain • microscopic hematuria • nausea • vomitingMedication: —Clinical Procedure: —Specialty: OncologyObjective:Rare diseaseBackground:Plasmacytoid is a rare histological variant of urothelial carcinoma (UC). Since the first reported case of plasmacytoid urothelial carcinoma (PUC), in 1991, only about 100 cases have since been reported, with most cases involving the bladder. Urothelial carcinomas of the upper urinary tract represent only 5% of urothelial cancers. To the best of our knowledge, there has only been 1 reported case of PUC of the ureter. PUC is a highly aggressive disease, with a poor prognosis. We present a rare biopsy-proven case of PUC of the ureter with retroperitoneal metastasis.Case Report:A 60-year-old man came into the hospital with complaints of a 5-day history of generalized abdominal pain, nausea, and vomiting, with no associated urinary symptoms prior to admission. CT demonstrated small bowel obstruction (SBO) and obstructive uropathy due to a right ureteric mass. Exploratory laparotomy, small bowel resection, gastrostomy tube placement, and umbilical hernia repair were all done. Histology and immunohistochemistry were compatible with plasmacytoid variant of urothelial cancer. He underwent a cystouretoscopy and a right ureteral stent placement with a right ureteroscopy. Final CT abdomen/pelvis revealed recurrent SBO before the ileocecal valve, possibly due to carcinomatosis. Ileocecal resection with end ileostomy placement was done. Systemic treatment will begin as an outpatient.Conclusions:PUC arising from the ureter is rare, and retroperitoneal metastatic disease has not been reported previously. Here, we compare the clinical manifestations of the more common PUC of the bladder with our case. From this we are able to learn more about the disease and its presentation.
Volume Number	19
PubMed Central reference number	PMC5819306
PubMed reference number	29434183
Journal	The American Journal of Case Reports [Am J Case Rep]
e-ISSN	19415923
DOI	10.12659/AJCR.906679
Language	English
Publisher	International Scientific Literature, Inc.
Publisher Date	2018-02-13
Access Restriction	Open
Rights License	This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) © Am J Case Rep, 2018
Subject Keyword	Plasmacytoma Retroperitoneal Neoplasms Ureteral Neoplasms Ureteral Obstruction Urinary Bladder Neoplasms
Content Type	Text
Resource Type	Article
Subject	Medicine