Upper Urinary Tract Urothelial Carcinoma Tumor Seeding along Percutaneous Nephrostomy Track: Case Report and Review of the Literature

Abstract

Upper urinary tract urothelial carcinomas (UTUC) account for 5-10% of all transitional cells neoplasms. Kidney-sparing treatment should be considered for low grade (LG) UTUC and for imperative conditions. Percutaneous approach may have a role in LG tumors not manageable endoscopically. Tumor seeding along nephrostomy track is a rare report. We describe the case of a 73-year-old male, with a history of high-grade UC of the left renal pelvis. A CT scan showed the thickening of left renal pelvic wall, and percutaneous biopsy was performed. The patient underwent laparoscopic left nephroureterectomy. Seven months later, he was admitted for left flank pain due to a mass along the percutaneous track site. Mass en-bloc resection was performed, and histopathology finding demonstrated undifferentiated carcinoma, compatible with UTUC metastasis. The percutaneous approach should be considered to be the possible cause of tumor seeding. Multimodal therapy seems mandatory, as highlighted in our outcomes, with 5 years of recurrence free survival.