A 63-year-old male was admitted to the emergency department with symptoms compatible with acute left pyelonephritis.
History of left nephritic colic not studied and hepatitis in youth.
Examination revealed a positive left renal percussion and rectal examination with prostatic hypertrophy volume III/IV, fibroadenomatous and no nodules.
Blood analysis with normal biochemistry, PSA 3.4 ng/ml and blood formula with leukocytosis and left shift.
Urine analysis with positive nitrites and leukocyturia.
Urocultive and hemocultive positive to E. Coli.
Simple X-ray of the urinary tract showed no significant pathological findings.
Ultrasound showed left renal ectasia grade II-III.
The UIV performed shows the right upper urinary tract within normal limits and delayed uptake and removal of contrast from the left kidney that persists after two hours.
Left derivative nephrostomy and subsequent anterograde pyelography were performed, which showed filling defect in the iliac ureter compatible with 3-4 cm ureteral tumor and ureter.
Cytology through negative nephrostomy and an extension study with CT showed that the lesion was confined to the organ of origin.
Left nephrectomy was performed prior endoscopic deinsertion, being the pathological result of inverted papilloma of ureter and left kidney with chronic pyelonephritis.
Two years later, the patient suffered an OOA, which recommends performing bladder voiding cyst resection. After 4 and 5 years of age, the patient developed recurrent transitional TGA bladder cancer.
The patient remains alive free of urothelial disease 6 years after the diagnosis of IP.
