Transitional cell cancer of the renal pelvis or ureter

Alternative names

Cancer - renal pelvis or ureter

Definition

Cancer of the renal pelvis or ureter involves the growth of cancerous cells in the collection system of the kidney. This includes the part of the kidney (the pelvis and its subdivisions or calyces) that empties urine into the ureter, which leads to the bladder.

Causes, incidence, and risk factors

As a group, renal pelvis and ureter carcinomas are uncommon and account for no more than 5% of all cancers of the kidney and upper genitourinary tract. They affect men more commonly than women and are more common in people older than 65.

Tumors of the renal pelvis and ureter are usually transitional cell cancers. Approximately 10% are squamous cell carcinomas.

The causes of this cancer are not completely known. Chronic irritation of the kidney from harmful substances excreted in the urine may be a factor and may result from the following:

• Smoking
  
• Analgesic nephropathy
  
• Exposure to aniline dyes and chemicals used in the manufacturing of leather goods, textiles, plastics, and rubber
  

Patients with a previous history of bladder cancer are also at risk.

Symptoms

• Back pain, located where ribs and spine meet
  
• Bloody urine
  
• Burning, pain, or discomfort with urination
  
• Dark, rust-colored, or brown urine
  
• Fatigue
  
• Flank pain
  
• Need to urinate frequently at night
  
• Unintentional weight loss
  
• Urinary frequency or urgency
  
• Urinary hesitancy
  

Signs and tests
Examination by touch (palpation) of the abdomen rarely reveals a mass or an enlarged kidney.

• Blood in the urine may appear.
  
• Complete blood count (CBC) may show anemia.
  

Cancer cells may appear on the following tests:

• Urine cytology (microscopic examination of cells) obtained during a cystoscopy
  
• Urine cytology obtained from a urine sample
  

The tumor, or signs of urinary obstruction, may appear on: