ABSTRACT
Metastasis from primary malignancies anywhere in the body can spread to the retroperitoneum and lead to ureteral obstruction. Seventeen patients who had ureteral obstructions caused by advanced gastrointestinal malignancies have been retrospectively analyzed. The results are as follows: 1) Of the 17 patients, 9 were male and 8 were female, and the mean age was 56.9: with a range from 33 to 75. 2) In the 16 patients whose pathologic diagnose were confirmed by primary surgery, the pathologic stages of stomach cancer were stage III in 1 patient and IV in 6 patients, and those of colorectal cancer were stage B in 2 patients, C in 6 patients and D in 1 patient. 3) Urologic symptoms and signs were micro- or macroscopic hematuria (58.8%), elevated BUN (52.9%), and flank pain (29.4%). Sixteen out of 17 patients had one of these findings. 4) The time interval between the original diagnosis of a gastrointestinal malignancy and the subsequent ureteral obstruction in 11 patients (64.7%) was within 2 years. The time interval for a11 17 patients was 33.9 months with a range from 2 months to 10 years. 5) Ureteral involvement was bilateral in 10 patients (58.8%) and unilateral in 7 (41.2%). The levels of ureteral obstruction in stomach cancer were upper (5) and midureter (3), and those in colorectal cancer were upper (1), mid (1) and lower ureter (7). 6) Twenty out of 27 kidneys were managed by a double-J stent (5 kidneys) or a percutaneous nephrostomy (15 kidneys). In conclusion, we believe that the possibility of ureteral obstruction by direct invasion or lymph node metastasis should be taken into account in patients who have advanced gastrointestinal malignancies. If such patients show hematuria, elevated BUN, or flank pain, a secondary ureteral obstruction should be suspected. Also malignant ureteral obstructions should be detected and managed early to preserve the renal function.
Subject(s)
Female , Humans , Male , Colorectal Neoplasms , Diagnosis , Flank Pain , Gastrointestinal Neoplasms , Hematuria , Kidney , Lymph Nodes , Neoplasm Metastasis , Nephrostomy, Percutaneous , Retrospective Studies , Stents , Stomach Neoplasms , Ureter , Ureteral ObstructionABSTRACT
Metastasis from primary malignancies anywhere in the body can spread to the retroperitoneum and lead to ureteral obstruction. Seventeen patients who had ureteral obstructions caused by advanced gastrointestinal malignancies have been retrospectively analyzed. The results are as follows: 1) Of the 17 patients, 9 were male and 8 were female, and the mean age was 56.9: with a range from 33 to 75. 2) In the 16 patients whose pathologic diagnose were confirmed by primary surgery, the pathologic stages of stomach cancer were stage III in 1 patient and IV in 6 patients, and those of colorectal cancer were stage B in 2 patients, C in 6 patients and D in 1 patient. 3) Urologic symptoms and signs were micro- or macroscopic hematuria (58.8%), elevated BUN (52.9%), and flank pain (29.4%). Sixteen out of 17 patients had one of these findings. 4) The time interval between the original diagnosis of a gastrointestinal malignancy and the subsequent ureteral obstruction in 11 patients (64.7%) was within 2 years. The time interval for a11 17 patients was 33.9 months with a range from 2 months to 10 years. 5) Ureteral involvement was bilateral in 10 patients (58.8%) and unilateral in 7 (41.2%). The levels of ureteral obstruction in stomach cancer were upper (5) and midureter (3), and those in colorectal cancer were upper (1), mid (1) and lower ureter (7). 6) Twenty out of 27 kidneys were managed by a double-J stent (5 kidneys) or a percutaneous nephrostomy (15 kidneys). In conclusion, we believe that the possibility of ureteral obstruction by direct invasion or lymph node metastasis should be taken into account in patients who have advanced gastrointestinal malignancies. If such patients show hematuria, elevated BUN, or flank pain, a secondary ureteral obstruction should be suspected. Also malignant ureteral obstructions should be detected and managed early to preserve the renal function.
Subject(s)
Female , Humans , Male , Colorectal Neoplasms , Diagnosis , Flank Pain , Gastrointestinal Neoplasms , Hematuria , Kidney , Lymph Nodes , Neoplasm Metastasis , Nephrostomy, Percutaneous , Retrospective Studies , Stents , Stomach Neoplasms , Ureter , Ureteral ObstructionABSTRACT
PURPOSE: Metastasis from primary malignancies anywhere in the body can spread to the retroperitoneum and lead to ureteral obstruction. We evaluated the correlation between pathologic stages of stomach cancer and ureteral obstruction, and their urologic manifestations. MATERIALS AND METHODS: Ten patients who had ureteral obstructions caused by stomach cancer were retrospectively analysed. Medical records associated with stomach cancer, urologic symptoms and signs, and methods of urinary diversion were reviewed. RESULTS: Pathologic stages of stomach cancer(UICC & AJC classification) at the time of primary surgery were stage III in 1 and IV in 8 patients. Mean time inteval between the diagnosis of stomach cancer and subsequent ureteral obstruction was 26.6 months(range: 2months-10years) and ureteral obstruction of 6 patients(60.0%) was discovered within 2 years. Urologic symptoms and signs were gross or microscopic hematuria(50.0%), elevated Cr(40.0%) and flank pain(40.0%). Nine out of 10 patients had one of these findings. Ureteral involvements were bilateral in 7(70.0%) and unilateral in 3 patients(30.0%). Sites of ureteral obstruction were upper ureter in 5 and midureter in 5 patients. 14 out of 17 obstructed kidneys were managed by double-J stent(7 kidneys) or percutaneous nephrostomy(7 kidneys). CONCLUSIONS: We believe that we should take into account the possibility of ureteral obstruction by direct invasion or lymph node metastasis in patients who had advanced stomach cancer. If such patients show hematuria, uremia or flank pain, secondary ureteral obstruction should be suspected. And malignant ureteral obstruction should be detected and managed as early as possible to preserve renal function.