14489              CARCINOMA OF URETER WITH HYDRONEPHROSIS

The patient was a man aged 58 who had severe intermittent pyuria 2 years before as a result of chronic prostatic abscess.  The prostate was removed.  Recently there had been almost painless haematuria and a block was found in the upper end of the ureter.  The kidney and ureter were resected.

The specimen comprises half a kidney 11 cms in length together with the upper 7 cms of the ureter.  A firm white mural thickening has produced narrowing of the ureteric lumen over a length of 3 cms.  The pelvic mucosa proximal to the tumour is haemorrhagic and there is moderate intrarenal hydronephrosis and hydrocalycosis.  The kidney tissue is pale but not grossly abnormal.  Histology shows infiltrating nests of carcinoma cells extending through the ureteric wall into adjacent lymphatic vessels.  The distal limit of the resected ureter was free of tumour.