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Malignancies of the renal pelvis and ureter

Authors
Jerome P Richie, MD, FACS
Philip W Kantoff, MD
Section Editor
Seth P Lerner, MD
Deputy Editor
Michael E Ross, MD

INTRODUCTION

The mucosal surfaces of the renal collecting tubules, calyces, and pelvis, as well as the ureter, bladder, and urethra, all have the same embryologic origin, and the term "urothelium" is used to delineate the lining surface epithelium [1]. This common embryologic origin has important implications for the management of patients with these tumors.

The clinical manifestations, diagnosis, and treatment of malignancies arising in the urothelium of the renal pelvis or ureter are reviewed here. Urothelial tumors originating in the bladder and urethra are discussed separately. (See "Overview of the initial approach and management of urothelial bladder cancer" and "Urethral cancer".)

PATHOLOGY

Primary tumors — Urothelial (also called transitional cell) carcinomas of the upper urinary tract, bladder, and urethra tend to be multifocal. This phenomenon is termed "field cancerization" and is thought to be caused by exposure of the urothelium to potential carcinogens that are either excreted in the urine or activated by hydrolyzing enzymes in the urine. (See "Pathology of bladder neoplasms" and "Epidemiology and risk factors of urothelial (transitional cell) carcinoma of the bladder", section on 'Risk factors'.)

Primary tumors arising in the renal pelvis include urothelial carcinomas, squamous cell carcinomas, and adenocarcinomas.

Over 90 percent of tumors of the renal pelvis and ureter are of urothelial origin and are histologically identical to those originating in the bladder.

                                 

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Literature review current through: Nov 2016. | This topic last updated: Wed Sep 28 00:00:00 GMT+00:00 2016.
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