Abstract
We report a case of peripelvic urinary extravasation associated with retroperitoneal invasion of descending colon cancer. A 65-year-old man visited our department for evaluation of a positive fecal occult blood test. Colonoscopy showed type Ⅳ descending colon cancer and biopsy of the tumor revealed poorly differentiated adenocarcinoma. Six weeks later, he suddenly complained of dull pain in the left flank and high fever. CT scan on emergency admission revealed left hydronephrosis and peri-ureteropelvic fluid collection. We suspected peripelvic extravasation and performed retrograde pyelograhpy. Pyelograhpy showed stenosis of the middle part of left ureter caused by invasion of descending colon cancer. A double-J stent was placed and further pyelograhpy revealed extravasation of contrast medium from the left renal pelvis. After the placing of a ureteral stent, complains disappeared immediately.
Although hydronephrosis caused by ureteral blockage is sometimes encountered due to invasion by advanced colon cancer, peripelvic extravasation is rarely encountered. One of the causes of peripelvic extravasation is rapid increase of the intra renal-pelvic pressure, so characteristics of rapid progression of poorly differentiated adenocarcinoma may accelerate the occurrence of extravasation.
