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52-year-old female w/gross hematuria. L ureter filling defect seen on CT, IVP and retrograde pyelography, admitted for L nephroureterectomy.
Abd/Pelvic CT: 12 to 15 mm intraluminal enhancing mass w/in the L ureter suspicious for neoplasm, especially transitional cell carcinoma. No regional/pelvic wall lymphadenopathy.
Cystoscopy/ L retrograde pyelography: no tumors seen in urethra or in bladder. L orifice easily visualized. Ureter at level of sacroiliac joint filling defect noted about 1cm and was persistent, did not appear to be air bubble. Ureter dilated in this region.
L kidney and ureter: pedunculated G1 papillary transitional cell carcinoma of mid-ureter, noninvasive. Tumor measures 1 x 1 x 2 cm. L kidney normal.
Surgery: Left nephroureterectomy.