A 73-year-old male with a history of surgical intervention for frontal squamous cell carcinoma, suprapubic adenomectomy (modulatory prostatic hyperplasia) in 1994, right recurrent nephritic colic, COPD and syndrome.
Clinically the patient presents dysuria, pollakiuria and initial hematuria without clots with good response to urinary antiseptic treatment.
Physical examination revealed rectal examination with empty cell.
Complementary tests: Analytical: normal coulter, normal coagulation, blood biochemistry with normal values except glucose 119.
Urocultiva was negative.
UIV: correct left renoureteral morphophysiology, important functional delay of the right kidney with severe ureter - pyelone - caliectasia to the juxtavesical ureter without objectifying cause of it.
Normal cystogram.
Perineal stricture - pelvic TAC: severe right ureterohydronephrosis up to bladder junction.
Cystoscopy: absence of UUD ejaculation, rest of the examination without relevant findings.
With the diagnosis of ureter right hiphronephrosis, right ureteral catheterization is attempted endoscopically and technically impossible by stop at 1 - 1.5 cm from the ureteral meatus.
Right percutaneous nephrostomy was performed, observing the existence of a right pyelic dilatation that ends abruptly at the mid ureter level compatible with urothelial neoplasia.
One month later, she underwent right radical nephroureterectomy with removal of the bladder stone.
Pathological anatomy.
1.
After these findings she was diagnosed with renal and right ureteral urothelial carcinoma, right hypernephroma and right hydronephrosis.
After a favorable postoperative period the patient is discharged.
Three months later, the patient came to the emergency department complaining of holocraneal headache for 1 month, behavior alteration, inability to walk, ataxia and worsening of her baseline situation of complete autonomy until the onset of symptoms.
A CT scan showed multiple lesions consistent with brain and cerebellar metastases.
The patient died two weeks after this admission.
