Upper tract local distal urothelial carcinoma managed with kidney-sparing surgery treatment - segmental ureterectomy: A clinical case

Abstract

Introduction Radical nephroureterectomy (RNU) represents the gold standard of care for managing upper tract urothelial carcinoma (UTUC) [1]. Recently, kidney-sparing surgery (KSS) – distal ureterectomy (DU) has emerged as a viable alternative, by removing only the affected portion of the ureter and allowing it to preserve kidney function [2]. Case presentation Six months ago, a 74-year-old female patient underwent treatment for pyelonephritis and sepsis. A CT scan was performed which revealed a nonspecific structure in the distal 1/3 of the left ureter. Therefore, cystourethroscopy and a biopsy were performed, which detected infiltrative papillary UTUC. A few months later, the patient was admitted to the urology department with complaints of macrohematuria and left-side pain. An RNU was scheduled, however, dynamic scintigraphy showed an impaired function of the right kidney. It was decided to perform a leftside DU, a pelvic lymphadenectomy, and a ureterocystoneostomy. Surgical procedures and recovery proceeded without any complications. Histological examination confirmed infiltrative papillary UTUC pT2N0R0G2. [...].