Abstract
An 83-year-old woman was seen by a local physician for a chief complaint of constipation with abdominal pain, and she was sent to our hospital with a suspected obstructive ileus. CT showed circumferential thickening of the descending colon wall, marked dilation of the proximal colon, left hydronephrosis, and a left upper ureteral mass. Imaging showed two lesions at separate sites. Because of a high risk of large bowel perforation, a colostomy with double transverse colon orifices was urgently performed on the same day as the referral. A colonoscopy, which was later performed, showed a stricture in the descending colon, but a biopsy showed no malignant findings. Urine cytology also showed no malignant findings, but clinically, the patient was diagnosed with double cancers of the descending colon and left ureter. A left hemicolectomy, left nephrectomy, and total resection of the left ureter were performed.
Macroscopic examination of the resected specimen showed hard fibrotic thickening of the descending colon wall, but the mucosal surface was intact, without evidence of colon cancer. Histopathology showed tissue resembling ureteral transitional cell carcinoma (TCC) in the descending colon wall, and the lesions were not contiguous, so the diagnosis was ureteral TCC with descending colon metastases. This rare case of ureteral TCC with colon metastases is reported.
