J Korean Soc Radiol.  2013 May;68(5):411-415.

Simultaneous Occurrence of Malignant Fibrous Histiocytoma of the Ureter and Dioctophyma Renale Infection: A Case Report

• Park HY
• Seo JW
• Lee BH
• Lee JY
• Kim SY
• Cha SJ
• Kim YH
• Hwang YJ
• Kim YS

Abstract

A common soft-tissue tumor, malignant fibrous histiocytoma (MFH) occurs in mainly limbs, retroperitoneal and peritoneal space, and occurrence in kidneys or the ureter is very rare. Dioctophyma renale (D. renale) since first discovered in dog's kidney was found in the kidneys of animals such as mink, coyote and weasel, and human infection has only been reported in only approximately 20 cases worldwide. MFH of the ureter and D. renale infection very rarely occur in humans, and has not been reported in our country. Here, we described the case of an adult man in whom MFH of the ureter simultaneously occurred with D. renale infection. An initial CT scan showed a well-defined, persistent, enhancing polypoid mass-like lesion in the upper ureter. After 10 months, D. renale was excreted in the urine and a follow-up CT scan showed an increase in the size of that lesion and irregular thickening of the ureter wall. The diagnosis of MFH was pathologically verified.

MeSH Terms

Adult
Animals
Coyotes
Dioctophymatoidea
Extremities
Follow-Up Studies
Histiocytoma, Malignant Fibrous
Humans
Kidney
Mink
Mustelidae
Ureter

Figure

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  Fig. 1 A 57-year-old man with malignant fibrous histiocytoma of the ureter and Dioctophyma renale (D. renale) Infection. A. Intravenous urography shows complete obstruction of left upper ureter at the level of L3 vertebral body upper endplate (arrow). B. Retrograde pyeloureterography shows a polypoid intraluminal filling defect in the left upper ureter (arrow). C. CT scan shows a persistent, enhancing well-defined polypoid mass-like lesion in the left upper ureter and mild hydronephrosis (arrow). D. The worm-like foreign material is excreted in urine. The foreign material is confirmed to be D. renale. E. Follow-up CT scan shows increase in the size of the mass in the upper left ureter; it also shows that the mass extended to the renal pelvis and to the more distal part of the ureter (arrow). Irregular wall thickening and enhancement of the left ureter with periureteral and peripelvic fat infiltration can be seen (arrowhead). F. The sectioned specimen shows a protruding, solid tan mass in the pelvis, measuring 6 × 4 cm. The tumor extends into the major calyx (arrowhead), pelvis, and proximal ureter (arrows) without invading the renal parenchyma. G. Sheets of bizarre cells with abundant eosinophilic cytoplasm and lymphoplasma cells are noted at microscopic view. The tumor cells are positive for CD68 on immunostaining (× 200).

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