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case_images: Pre-treatment imaging. Abdominal contrast-enhanced CT revealed a left ureteral tumor.
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case_images: CT. Contrast-enhanced CT confirmed the diagnosis of left renal pelvic and ureteral cancer (cT3N0M0) (Fig. 1).
case_images: Gross and microscopic findings of the renal and ureteral tumors. (a) Lesions extending from renal pelvis to ureter. (b) UC showing papillary structures with parenchymal invasion (Elastica Van Gieson staining, x20). (c) Stratified cellular structures with stratification centered on the stroma (H&E staining, x100).
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case_images: The pathological diagnosis revealed UC at the pT3 stage, with the tumor extending from the renal pelvis to the lower ureter, although with negative surgical margins (Fig. 2a,b). No cellular component in this lesion displayed differentiation into squamous epithelium (Fig. 2c).
case_images: Post-recurrence imaging. (a) MRCP showed a peritoneal lesion (diffusion weighted imaging). (b, c) PET-CT showing FDG uptake in the peritoneal lesions.
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case_images: Then, 10 years after nephroureterectomy, a MRCP imaging incidentally revealed a mass lesion in the left retroperitoneum (Fig. 3a), and a PET-CT scan showed abnormal FDG uptake at the same site (SUVmax = 12.08) (Fig. 3b,c).
case_images: Microscopic findings of the peritoneal lesion (CT guided biopsy). (a) Tumor tissue with abundant fibrous components (H&E staining, x20). (b) SCC with keratinization (H&E staining, x400). (c) SCC with intercellular bridges (H&E staining, x1000). (d-f) Pathological findings are positive for cytokeratin5/6 (d), P40 (e), and P63 (f).
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case_images: The histology of the retroperitoneal recurrent lesion showed SCC with keratinization and intercellular bridges (Fig. 4a-c). Immunohistochemical staining was diffusely positive for cytokeratin 5/6, P40 and P63 (Fig. 4d-f).