PMC9539752_01
CTU of case 1. (A) Baseline: arrows show the UC in the bilateral renal pelvis with parenchyma invasion. (B) After three cycles: arrowheads show a residual tumor in the left upper calyx. (C) CTU revealed no recurrence after five cycles. (D) Showing a suspected lesion at the right middle ureter in URS with dysplasia in the pathology report. (E) CTU revealed no recurrence in the latest follow-up (January 2021).
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f1
Her computed tomography (CT) of the abdomen revealed a tumor in the bilateral renal pelvis with renal parenchyma invasion (Figure 1A), and the pathology report from retrograde ureterorenoscopy biopsy showed high-grade invasive urothelial carcinoma (UC), while immunohistochemistry analysis revealed a high expression of programmed death-ligand-1 (PD-L1; Dako 22C3 pharmDx assay, Agilent Technologies, Santa Clara, California, USA) with a tumor proportion score of 60% in July 2018. Thereafter, her CT urography (CTU) showed a complete response of the right renal pelvis UC but a partial response of the left renal pelvis UC (Figure 1B). CTU was followed up 5 weeks after the last immunotherapy, which revealed negative local recurrence (Figure 1C). Right ureterorenoscopy (URS) showed a suspected lesion in the middle ureter with a pathology report indicating dysplasia in January 2019 (Figure 1D). Surveillance by CT images, urine cytology, and cystoscopy every 6 months was suggested, and all negative results of recurrence, including the previous suspicious dysplasia site, were reported even in the latest CTU in January 2021 (Figure 1E).
PMC9539752_02
CTU of case 2. (A) Baseline: arrows show the UC in the bilateral renal pelvis with parenchyma invasion. (B) After three cycles: shows remission of bilateral tumors.
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f2
Her noncontrast CT of the abdomen revealed a tumor in the bilateral renal pelvis with renal parenchymal invasion and a right ureteral tumor (Figure 2A). CT of the abdomen showed regression of bilateral renal pelvis tumors thereafter (Figure 2B).