Primary neuroendocrine tumors of the upper urinary tract are extremely rare. We report a case of de novo small cell carcinoma of the ureter that presented masquerading as a distal ureteral stone. A 55-year-old lady presented to our clinic with 1 month history of right lower back pain and hematuria. Her history was notable for stage 1B mixed clear cell-endometroid cancer of the uterus status post radical abdominal hysterectomy with adjuvant radiotherapy, 7 years before the current episode. The patient had no evidence of recurrence. Initial noncontrast imaging suggested a 2.5 mm calculus in the distal right ureter and hydronephrosis; however, ureteroscopy revealed a large fleshy mass at the location. Histopathologic evaluation demonstrated the lesion to be primary small cell carcinoma of the ureter, without evidence of it being a derivative of the prior gynecologic malignancy. Metastatic work-up revealed high burden retroperitoneal adenopathy. The patient was started on Cisplatin-based neoadjuvant chemotherapy with plan for nephroureterectomy in the future. At 3 months follow-up, the patient was doing well with significant shrinkage of retroperitoneal adenopathy and no evidence of disease progression.
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Sood, A., Williamson, S. R., & Leavitt, D. A. (2016). Neuroendocrine Tumor of the Ureter: A Zebra Among Horses. Journal of Endourology Case Reports, 2(1), 204–208. https://doi.org/10.1089/cren.2016.0103