Endometrioid adenocarcinoma in the native ureter of a renal transplant patient: case report and review of the literature

Kelly A. Healy, Healy KA, Kenneth J Carney, K. Jeff Carney, Carney KJ, Osunkoya AO, Adeboye O. Osunkoya
TheScientificWorldJournal · 2010 · vol. 10 , pp. 1714–1722 · doi:10.1100/tsw.2010.166 · PMID:20842317 · PMC5763830 · W2154486116
Review OA: gold CC0 ⤵ 6 in-corpus citations
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This case report describes endometrioid adenocarcinoma arising in the native ureter of a renal transplant patient with a history of endometriosis and unopposed estrogen therapy, highlighting the importance of considering malignant degeneration.

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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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Condition tags

endometriosis

MeSH descriptors

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

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (15)

Cited by (7)

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