Ureteral stump metastasis from renal adenocarcinoma: case report and literature review.

The occurrence of metastasis along the ureteral stump after previous radical nephrectomy for renal adenocarcinoma is very rare, only 47 cases having been reported in the literature. We present a case of metastasis of renal adenocarcinoma, occurring in the ureteral remnant, more than three years after ipsilateral radical nephrectomy. The analysis of this and previously reported cases leads us to propose radical nephro-ureterectomy as treatment of choice in certain cases of renal adenocarcinoma, instead of radical nephrectomy alone, notably when preoperative urine-cytology shows the presence of adenocarcinoma cells, and/or when vascular tumor infiltration is present. This adjuvant surgical step is of course only justified in those cases where a reasonable life-expectancy is present at the time of diagnosis, and thus especially applicable in the smaller T2 tumor group.