J Korean Soc Radiol.  2014 Dec;71(6):320-323. 10.3348/jksr.2014.71.6.320.

Primary Leiomyoma of Ureter Coexisting with Renal Cell Carcinoma: A Case Report

• Baek SH
• Kim HJ
• Han HY

• KMID: 1801556
• DOI: http://doi.org/10.3348/jksr.2014.71.6.320

Abstract

Mesenchymal origin of ureter tumors account for less than 3 percent of all primary ureteral tumors. Among mesenchymal tumors, primary leiomyoma of ureter is extremely rare. Here, we present a case of primary leiomyoma of ureter coexisting with renal cell carcinoma. When encountering well-defined homogeneously enhanced mass of ureter on computed tomography, radiologist should keep in mind that ureteral leiomyoma should be considered as differential diagnosis.

MeSH Terms

Carcinoma, Renal Cell*
Diagnosis, Differential
Leiomyoma*
Ureter*

Figure

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  Fig. 1 50-year-old woman with primary leiomyoma of the ureter. A. Contrast-enhanced abdomen CT shows well-defined small homogeneously enhancing mass (about 1.4 × 1.1 cm) at the medial aspect of the left distal ureter. The periureteral mass (arrow) was compressing the left distal ureter. B. Contrast-enhanced abdomen CT shows obstructive hydronephrosis and hydroureter of the left kidney (arrow) and slightly decreased enhancement of renal parenchyma suggesting obstructive uropathy. C. Microscopic image of the mass shows well-differentiated multiple layers of hypercellular and hyperchromatic interwoven bundles of smooth muscle cells (H&E, × 40). D, E. On the immunohistochemical staining, the spindle cells were positive for the smooth muscle actin (SMA) (D) and vimentin (E) (SMA, × 100, vimentin, × 100).

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  Fig. 2 Coexistent renal cell carcinoma in the mid-portion of the left kidney. A, B. Contrast-enhanced abdomen CT with axial scan shows 1.4 × 1.3 cm sized hypervascular mass (arrow) in the mid-portion of left renal parenchyma. This mass showed hyperenhancement on corticomedullary phase (A) and washout of enhancement on excretory phase (B). It was considered as a renal cell carcinoma. C. Micrograph shows epithelial cells with clear cytoplasm and a distinct cell membrane, separated by a delicate branching network of vascular tissue (H&E, × 100). It is typical histologic findings of renal clear-cell carcinoma.

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