case_images: PMC11830114_01
case_images: (A) Cystourethroscopy image showing a tumor in the right renal pelvis; (B) Cystoscopy image showing a growth extruding into the bladder
case_images: cureus-0017-00000077562-i01.jpg
case_images: PMC11830114_01_cureus-0017-00000077562-i01.jpg
case_images: FIG1
case_images: Diagnostic cystourethroscopy (Figure 1) showed a tumor arising from the right renal pelvis running through the entire right ureter, extruding into the bladder from the right ureteric orifice.
case_images: A CT image showing a tumor arising from the right renal pelvis running through the entire right ureter extruding into the bladder (A) from the right ureteric orifice (B) and MRI images showing the tumor extruding into the bladder lumen (C) and (D).. CT: computed tomography; MRI: magnetic resonance imaging
case_images: cureus-0017-00000077562-i02.jpg
case_images: PMC11830114_01_cureus-0017-00000077562-i02.jpg
case_images: FIG2
case_images: Endophytic pedunculated enhancing mass lesion, measuring 2.8x3.7x1.8 cm, arising from the right vesicoureteric junction, extending into the right distal ureter, causing dilatation of the ureter, for a length of about 15 cm was observed (Figure 2).
case_images: Intraoperative images showing a dilated ureter and right kidney. Both the images are intraoperative and the tumors have been marked by an arrow.
case_images: cureus-0017-00000077562-i03.jpg
case_images: PMC11830114_01_cureus-0017-00000077562-i03.jpg
case_images: FIG3
case_images: She underwent laparoscopic right radial nephroureterectomy and bladder cuff excision (Figure 3) combined with bilateral salpingo-oophorectomy and hysterectomy.
case_images: (A) Pale white polypoidal growth from the distal pelvicalcyeal system and proximal ureter renal pelvis containing fibrofatty tissue containing gelatinous fluid; (B) Shrunken right kidney with congested outer surface covered with perinephric fat, dilated ureter measuring 21cm with endophytic polypoidal growth, extending into the bladder
case_images: cureus-0017-00000077562-i04.jpg
case_images: PMC11830114_01_cureus-0017-00000077562-i04.jpg
case_images: FIG4
case_images: On gross examination (Figure 4), the shrunken right kidney measured 6.3x4.6x2.7 cm, with the ureter measuring 21 cm.
case_images: Urothelium arranged in nests and focal tubules. Stroma appears loose and fibromyxoid as shown in the histopathological slide.
case_images: cureus-0017-00000077562-i05.jpg
case_images: PMC11830114_01_cureus-0017-00000077562-i05.jpg
case_images: FIG5
case_images: Microscopic analysis (Figure 5) revealed a two-phase pattern with epithelial elements comprised of columnar cells and stromal components of spindle cells with abundant cytoplasm with plump nuclei.
case_images: PMC11830114_02
case_images: (A) Left kidney with a bosselated surface; (B) A pale, white, polypoid mass originating in the central region of the kidney and spreading into the pelvicalyceal system as well as the ureter.
case_images: cureus-0017-00000077562-i06.jpg
case_images: PMC11830114_02_cureus-0017-00000077562-i06.jpg
case_images: FIG6
case_images: A gross pathological examination (Figure 6) revealed a markedly enlarged left kidney with a lobulated surface.
case_images: PMC11830114_03
case_images: (A) A CT image showing a tumor arising from the lower pole of left kidney; (B) Extension of the tumor into the left renal pelvis. CT: computed tomography
case_images: cureus-0017-00000077562-i07.jpg
case_images: PMC11830114_03_cureus-0017-00000077562-i07.jpg
case_images: FIG7
case_images: Venous contrast CT and urographic CT scan of the abdomen were performed (Figure 7).
case_images: A greyish white mass bulging into the pelvis and the proximal portion of ureter
case_images: cureus-0017-00000077562-i08.jpg
case_images: PMC11830114_03_cureus-0017-00000077562-i08.jpg
case_images: FIG8
case_images: Gross pathologic examination showed a well-demarcated gray-white lesion (Figure 8) measuring 8x3.7x2.7 cm in the lower pole, having both solid and cystic areas, bulging into the proximal portion of the ureter into the hilum and breaching the capsule to produce a protrusion on the outer aspect involving the cortex and medulla.
case_images: A well-circumscribed tumor comprising cysts and glands of differing sizes, lined with cuboidal urothelial cells and fibromyxoid stroma with cystic septae forming solid areas of the tumor
case_images: cureus-0017-00000077562-i09.jpg
case_images: PMC11830114_03_cureus-0017-00000077562-i09.jpg
case_images: FIG9
case_images: Microscopy (Figure 9) showed well-circumscribed tumor areas comprising cysts and glands of differing sizes, lined with cuboidal urothelial cells and fibromyxoid stroma with cystic septae forming solid areas of the tumor.
case_images: PMC11830114_04
case_images: (A) A CT image showing a tumor arising from the left kidney; (B) A tumor displacing the stomach anteriorly, spleen anterolaterally with maintained fat planes; (C) Feeding artery noted arising from the left renal artery; (D) Exophytic mass protruding out from the renal pelvis . CT: computed tomograhy
case_images: cureus-0017-00000077562-i10.jpg
case_images: PMC11830114_04_cureus-0017-00000077562-i10.jpg
case_images: FIG10
case_images: A large, well-defined heterogeneously enhancing mass (Figure 10) of 13x9.3x11.5 cm (anteroposterior (AP) x transverse (TR) x craniocaudal (CC)) was noted arising from the upper pole of the left kidney lesion and showed multiple non-enhancing hypodense regions within suggestive of necrotic areas with areas of internal calcifications and hyperdense areas suggestive of hematoma.
case_images: (A) Nodular and bosselated outer surface; (B) The cut surface having a well-circumscribed large gray-white solid tumor, displacing the kidney parenchyma into the periphery.
case_images: cureus-0017-00000077562-i11.jpg
case_images: PMC11830114_04_cureus-0017-00000077562-i11.jpg
case_images: FIG11
case_images: The specimen measured 16x13x6.5 cm (Figure 11).