Tuberc Respir Dis.  2013 Jul;75(1):32-35.

Late-Onset Distant Metastatic Upper Urinary Tract Urothelial Carcinoma Mimicking Lung Adenocarcinoma

• Lim JH
• Jeon SH
• Lee JM
• Kim L
• Cho JH
• Ryu JS
• Kwak SM
• Lee HL
• Nam HS

Abstract

Urothelial carcinomas (UCs) can occur in the upper urinary tract or lower urinary tract. Upper urinary tract urothelial carcinoma (UUT-UC) is relatively a rare disease and accounts for only about 5% of UC cases. Sporadic cases of late-onset metastasis, associated with UC of the bladder, have occasionally been reported. In contrast, no late-onset distant metastatic UUT-UC without local recurrence has, to the best of our knowledge, been reported in the English literature. We report an extremely rare case of distant metastatic UC, mimicking lung adenocarcinoma that originated from UUT-UC 12 years previously.

Keyword

Carcinoma; Urothelium; Urinary Tract; Adenocarcinoma of Lung

MeSH Terms

Adenocarcinoma
Lung
Lung Neoplasms
Neoplasm Metastasis
Rare Diseases
Recurrence
Urinary Bladder
Urinary Tract
Urothelium
Adenocarcinoma
Lung Neoplasms

Figure

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  Figure 1 Histopathological findings of the biopsied tissue (A-C, H&E stain, ×400). (A) Primary urothelial carcinoma was low grade diffusely involving renal pelvis with subepithelial connective tissue invasion 12 years ago. (B) The tumor of the lung, which was initially suspected as primary lung adenocarcinoma, is revealed as metastatic urothelial carcinoma showing similar histologic features to primary urothelial carcinoma. (C) After chemotherapy, the tracheal tumor cells showing more pleomorphic and anaplastic cytologic features with individual tumor cell infiltration.

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  Figure 2 Immunohistochemical finding of metastatic urothelial carcinoma of trachea showing that tumor cells were positive for cytokeratin 7 (CK7) (A) and p63 (B) (A and B, ×200).

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  Figure 3 (A) Chest computed tomography and (B) 18F-fluorodeoxyglucose positron emission tomography/computed tomography performed after chemotherapy showing left lower paratracheal lymphadenopathy with tracheal invasion and abnormal FDG uptake of subcarinal lymphadenopathy and left lower lobe mass.

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