Contralateral ureteral metastasis 4 years after radical nephrectomy

AbstractIntroductionMetastasis of renal cell carcinoma to the contralateral ureter is extremely rare. To date, only 50 cases of metastatic RCC to the ureter have been reported, among whom 6 cases occur at the contralateral site. We herein report a rare case of metastatic RCC in the contralateral ureter 4 years after radical nephrectomy.Presentation of caseA 74-year-old man presented with gross, painless hematuria for one month. Computed tomography scan confirmed that a 1.5cm×0.5cm tumor occurred in the contralateral distal ureter. A 3.5cm segment of ureter was resected and a uretero-vesical anastomosis with psoas hitch was accomplished.DiscussionThe reappearance of hematuria after radical nephrectomy is the most common manifestation of the metastasis to the bladder or ureter. The mechanism of metastasis is not clear. In pathology, vimentin and cytokeratins might help to differentiate between metastatic clear cell renal cell carcinoma and clear cell transitional cell carcinoma.ConclusionMetastasis of renal cell carcinoma to the contralateral ureter is rare. Early recognition is extremely important in protecting the remaining renal function and prolonging life-expectancy for post-nephrectomy patients. Complete metastectomy suitable anastomosis have been shown to improve survival