PMC10176196_01
Initial CT scan of patient with infiltrating urothelial carcinoma, sarcomatoid variant.
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F1
CT scan with contrast demonstrated a 1.3 cm x 1.3 cm x 1.4 cm mass in the 1/3 distal of the right ureter with hydroureter and hydronephrosis (shown in Fig. 1).
a Macroscopic tissue of the kidney and ureter. b On lamellar excision of the kidney, multiple lobes filled with reddish-yellow fluid were seen with a mass filling the lumen of the ureter.
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F2
Postsurgical gross examination found a mass filled the lumen of the ureter with a size of 5.5 x 3 cm with a distance of 6 cm from the tip of the distal ureter and 2.5 cm from the renal pelvis (shown in Fig. 2a, b).
Microscopic ureter mass. Pleomorphic transitional epithelial proliferation mixed with sarcomatoid components arranged in fasciculus with spindle-shaped enlarged nuclei, coarse and hyperchromatic, mitosis easy to find (HE, x100).
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F3
Morphologic and immunohistochemistry findings were consistent with infiltrating urothelial carcinoma with some focus showing the sarcomatoid component consisted of pleomorphic cells arranged in fasciculus with spindle-shaped nuclei, coarse chromatin with partially hyperchromatic, mitosis is easily found, and eosinophilic cytoplasm (shown in Fig. 3).
PET-CT scan showed that there was no suspicious residual malignancy in the kidney post-RNU and post-chemotherapy.
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F4
The PET-CT scan results showed no suspicious residual malignancy or malignancy/metastasis in the left kidney and no metastasis in the lymph nodes, lungs, heart, and bones (shown in Fig. 4).