Primary leiomyosarcoma of the ureter: A case report

Malignant tumors of the smooth muscle of the ureter are extremely rare, with ~13 cases of leiomyosarcoma of the ureter being reported to date. A 59-year-old Caucasian woman presented to 'Umberto I' Hospital (Nocera Inferiore, Italy) with acute abdominal pain, predominantly in the right lumbar fossa. The patient exhibited a functional single kidney, due to left renal atrophy for a long-standing stenosis of the pyelo-ureteric joint. With the exception of this condition and hypertension (under medical therapy), the patient was in excellent clinical condition. Furthermore, the patient was not a smoker. Computed tomography indicated a stricture with a peri-ureteral soft tissue mass of 45×52 mm at the middle third of the ureter at the level of common iliac vessels. Laparoscopic excision with safety margin and a right tension free end-to-end anastomosis between the two stumps of the ureter was performed. The diagnosis of leiomyosarcoma of the right ureter was made by pathological examination. Although leiomyosarcoma is rarely noted in the urinary tract, it should be considered in the differential diagnosis of ureteral stricture disease and retroperitoneal tumors.