case_images: PMC8178004_01
case_images: CT findings. (a) Plain CT at diagnosis shows a right invasive ureteral tumor and no metastatic findings ((a) arrow). (b) Plain CT after four course of chemotherapy shows the right ureteral tumor diminished in size after the therapy ((b) arrow).
case_images: CRIU2021-5599014.001.jpg
case_images: PMC8178004_01_CRIU2021-5599014.001.jpg
case_images: fig1
case_images: Plain CT showed a right invasive ureteral tumor and no renal tumors and no metastatic findings (Figure 1(a)). The cancer cells in urine were disappeared, and the right ureteral tumor diminished in size after the therapy (Figure 1(b)).
case_images: Pathological findings. Histopathological findings reveal that urothelial carcinoma in situ ((a) UC) persisted in part; however, most of the tumor is clear cell adenocarcinoma ((a) CCA) ((a) hematoxylin and eosin). The clear cell adenocarcinoma lesion has clear cytoplasm with round nuclei and visible nucleoli in an insular arrangement. No transitional lesion between clear cell adenocarcinoma and urothelial carcinoma can be presented in this lesion. The clear cell adenocarcinoma lesion is CK7 negative (b), CK5/6 negative (c), CK20 negative (d), GATA3 negative (e), and HNF4alpha positive (f). The urothelial cancer lesion is CK7 positive (b), CK5/6 weak positive (c), CK20 positive (d), GATA3 positive (e), and HNF4alpha negative (f). CCA: clear cell adenocarcinoma; UC: urothelial carcinoma.
case_images: CRIU2021-5599014.002.jpg
case_images: PMC8178004_01_CRIU2021-5599014.002.jpg
case_images: fig2
case_images: The clear cell carcinoma lesion was CK5/6 negative, CK20 negative, GATA3 negative, CK7 negative, 34beta-E12 negative, CD10 positive, EMA weak positive, vimentin negative, HNF4alpha positive, Uroplakin negative, PAX8 negative, and CEA weak positive; however, the urothelial cancer lesion was CK7 positive, CK5/6 weak positive, CK20 positive, GATA3 positive, 34beta-E12 negative, CD10 weak positive, EMA weak positive, vimentin negative, HNF4alpha negative, Uroplakin weak positive, PAX8 weak positive, and CEA negative (Table 1, Figure 2).