Endometrioid Adenocarcinoma in the Native Ureter of a Renal Transplant Patient: Case Report and Review of the Literature

Kelly A Healy, Kenneth J Carney, K. Jeff Carney, Adeboye O Osunkoya
TheScientificWorldJournal · 2010 · vol. 10 , pp. 1714–1722 · doi:10.1100/tsw.2010.166 · PMID:20842317 · PMC5763830 · W2154486116
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Abstract

Endometriosis is characterized by endometrial-like tissue outside the uterus, primarily on the pelvic peritoneum, ovaries, and rectovaginal septum, and, in rare cases, within the urinary tract (1-3%). Although endometriosis is a benign condition, malignant transformation of endometriosis is a well-described phenomenon. Malignancies arising in endometriosis are uncommon at extragonadal pelvic sites. A case of endometrioid adenocarcinoma in the native ureter of a postmenopausal renal transplant patient presented with painless gross hematuria and hydroureteronephrosis. The patient had a history of total abdominal hysterectomy and bilateral salpingo-oophrectomy 14 years prior for menorrhagia and had since been on unopposed estrogen replacement therapy. Workup revealed a filling defect in the native left mid-ureter secondary to a large 2.5-cm ureteral tumor. Endoscopic biopsies of the native left ureteral mass showed endometrioid adenocarcinoma, grade II-III. The patient ultimately underwent an open native left nephroureterectomy and temporary diverting colostomy. Final pathology confirmed endometrioid adenocarcinoma, grade II-III, arising in a background of endometriosis with negative perirectal lymph nodes. This case of ureteral endometrioid adenocarcinoma highlights the importance of obtaining a careful history and maintaining a high index of suspicion for malignant degeneration, especially in the context of hyperestrogenism.

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endometriosis

MeSH descriptors

Carcinoma, Endometrioid Endometrial Neoplasms Kidney Transplantation Ureter Carcinoma, Endometrioid Carcinoma, Endometrioid Endometrial Neoplasms Endometrial Neoplasms Endometriosis Endometriosis Female Humans Middle Aged Ureter

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