case_images: PMC11341426_01
case_images: (A) Preoperative CTU scan revealing a 14.2x6.7mm swelling in the lower right ureter (red arrow, panel A). (B, C) CTU scans 40 months post-operation. B displays the anterior view and C the lateral view, indicating the anastomosis sites of the ileum segment with the ureter (upper arrow) and the bladder (lower arrow) (panels B, C).
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case_images: PMC11341426_01_fonc-14-1426003-g001.jpg
case_images: f1
case_images: To investigate the cause of hematuria, the patient underwent computed tomography urography (CTU), which revealed a swollen and dilated area measuring 14.2x6.7mm in the right lower ureter ( Figure 1A ). CTU performed at 40 months post-surgery showed no tumor recurrence and no significant stenosis, mucus obstruction, calcification, or stone formation in the reconstructed ureter ( Figures 1B, C ).
case_images: (A) HE stain of the preoperative biopsy showing high-grade non-invasive urothelial cancer. The red arrow denotes the cancer cell mass (magnification 40x, panel A). (B) Local magnified view of the cancer cell cluster from panel A (magnification 100x, panel B). (C) HE stain of the ureteral specimen post-surgical resection, indicating high-grade non-invasive urothelial carcinoma. The specimen's cut end shows no tumor involvement, consistent with preoperative findings (magnification 100x, panel C).
case_images: fonc-14-1426003-g002.jpg
case_images: PMC11341426_01_fonc-14-1426003-g002.jpg
case_images: f2
case_images: A biopsy of the lesion confirmed a diagnosis of high-grade non-invasive papillary urothelial carcinoma (T1G1,  Figures 2A, B ). Postoperative pathology confirmed local focal high-grade non-invasive urothelial carcinoma in the right ureter, with no tumor involvement at the resected ureteral end ( Figure 2C ).
case_images: Schematic diagram of the surgical procedure.
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case_images: PMC11341426_01_fonc-14-1426003-g003.jpg
case_images: f3
case_images: The main surgical steps are described as follows(The schematic diagram of the surgical procedure is shown in  Figure 3 ): make an incision beside the right rectus abdominis to open the abdominal cavity, enter the retroperitoneal cavity, expose the right middle and lower ureter and the vesicoureteral junction, perform the diseased ureter and bladder sleeve resection, the removed ureter is about 10cm long, cut off an ileum segment of about 15cm at least 15cm away from the ileocecum, longitudinally cut off half of the collected ileum, and longitudinally separate the ileum mucosa with the blade of blunt surgical scissors.
case_images: Disease diagnosis, treatment and follow-up time line.
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case_images: PMC11341426_01_fonc-14-1426003-g004.jpg
case_images: f4
case_images: The diagnostic, therapeutic, and follow-up processes of this case are illustrated in  Figure 4 .