Korean J Nephrol.  2004 Jul;23(4):638-643.

A Case of Analgesic Nephropathy Complicated by Transitional Cell Carcinoma of the Ureter

• Park JT
• Kim HJ
• Chang T
• Lee JE
• Lee SC
• Lim JK
• Kang SW
• Han DS
• Lee HY
• Chung HJ
• Choi KH

Abstract

Following a report by Hultengren et al. (Acta Chir Scand, 1965), it has been suggested that analgesic abuse predisposes to urothelial neoplasia. Urinary tract malignancy is combined in 8-10% of patients with analgesic nephropathy. Microscopic or gross hematuria can be the first sign leading to the diagnosis of uroepithelial malignanacy in analgesic abusers. Since uroepithelial malignancies found in analgesic abusers tend to be multiple and have a worse prognosis, continued monitoring is essential, and new hematuria should be evaluated with urinary cytology, and cystoscopy with reterograde pyelography. Phenacetin found to be the chief cause of malignancies in analgesic abusers, it has been anticipated to be a human carcinogen and was banned as an OTC drug since 1987. But still there remains a debate whether acetaminophen and other compound analgesic components are carcinogenic. We report the case of a 58-year-old man with a history of analgesic abuse who was diagnosed with transitional cell carcinoma combined with analgesic nephropathy. We also review the literature.

Keyword

Analgesics; Nephropathy; Uroepithelial carcinoma; Papillary necrosis; Interstitial nephritis

MeSH Terms

Acetaminophen
Analgesics
Carcinoma, Transitional Cell*
Cystoscopy
Diagnosis
Hematuria
Humans
Middle Aged
Nephritis, Interstitial
Phenacetin
Prognosis
Ureter*
Urinary Tract
Urography
Acetaminophen
Analgesics
Phenacetin