Genitourinary Radiology > Collecting System > Ureters > Transitional Cell Carcinoma

Transitional Cell Carcinoma


Transitional cell carcinoma is the most common neoplasm of the ureter (85%); others include squamous cell carcinoma (5%), adenocarcinoma (1%), and benign tumors (10%). Transitional cell carcinoma shows a propensity for multifocal disease: if the ureter is involved, 40% will have multifocal disease, usually on the ipsilateral ureter or in bladder. 2/3 are papillary, 1/3 are infiltrative.

As with its bladder counterpart, ureteral transitional cell carcinoma peaks at age 50-69 years, with men being affected 3 times as often as women. Risk factors include chemical carcinogens (acrolein, aromatic amines, nitrosamines), analgesic use, and tobacco smoking. Infiltrative TCC is more likely to metastasize, and papillary TCC is often multi-focal with high recurrence rates.

Excretory phase of conventional Intravenous Urogram (IVU) in a patient with hematuria shows a filling in the left upper pole calyx (arrow). Ureteroscopy showed a mass consistent with transitional cell carcinoma and the patient underwent nephroureterectomy.

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