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Il Giornale Italiano di Radiologia Medica 2019 Settembre-Ottobre;6(5):471-4

DOI: 10.23736/S2283-8376.19.00198-0

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

Partial spontaneous break of proximal ureter and urinoma caused by clear renal cell carcinoma and clots: case report and literature review

Maria C. DI MARCO 1 , Maria L. LANZA 1, Oriana R. MONTALBANO 2, Claudia CALI 3, Rosario GRECO 1

1 Unit of Radiology, Gela “Vittorio Emanuele” Hospital, ASP 2 Caltanissetta, Caltanissetta, Italy; 2 Department of Medical and Forensic Biopathology and Biotechnology (DIBIMEF), University of Palermo, Palermo, Italy; 3 Unit of Urology, Gela “Vittorio Emanuele” Hospital, ASP 2 Caltanissetta, Caltanissetta, Italy


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Spontaneous break of the proximal ureter is a rare event and it is usually associated with nephrolithiasis. It may be also the evolution of neoplastic ureteral process or a complication of retroperitoneal fibrosis. Much rarer is the obstruction caused by clots resulting from renal cell carcinoma involving kidney’s calices. Pain, hematuria are the most common symptoms. A 51-year-old man arrived at our emergency department for a strong right flank pain. After the clinical evaluation of the urologist in the suspicion of colic due to ureteral calculus, a computed tomography scan without contrast medium was requested. Multiple detector computed tomography (MDCT) was performed without and later with contrast medium and it detected a big neoplasia of the right kidney, with parenchimatous density, fairly vascularized, with idronefrosis, clots and periureteral urinoma extended to the retroperitoneum. Immediate stenting JJ was subsequently followed by radical nephrectomy after two weeks, with histological diagnosis of clear renal cell carcinoma. Spontaneous rupture of the ureter is a rare event. MDCT plays a crucial role in diagnosis of renal tumor. The diagnosis must be confirmed by histological exam and the urinoma must be treated with the most accurate therapeutic choices.


KEY WORDS: Tomography, X-ray computed; Carcinoma, renal cell; Urinoma

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