Ureteral neoplasms

The authors review primary and secondary neoplastic lesions of the ureter. Primary ureteral tumors are rare, although when they occur, they usually consist of transitional cell carcinoma. The most frequent symptoms are hematuria, frequency, dysuria, and pain. Secondary ureteral neoplasms are caused by direct extension from an adjacent extraureteral primary tumor or from a site of bulky metastasis and, rarely, by metastasis from a distant primary tumor. The most useful diagnostic modalities are retrograde pyelography for direct visualization of ureteral involvement--particularly in the presence of high-grade obstruction--and computed tomography for evaluation of extraureteral extent of tumors and the presence of lymphadenopathy and distant metastases.