Journal of Ultrasound in Medicine, Vol 18, Issue 9 639-645, Copyright © 1999 by American Institute of Ultrasound in Medicine
Sonographic diagnosis of ureteral tumors
I. Hadas-Halpern, A. Farkas, M. Patlas, I. Zaghal, S. Sabag-Gottschalk and D. Fisher
Department of Radiology, Shaare Zedek Medical Center, Jerusalem, Israel.
We present our experience with transabdominal ultrasonographic diagnosis of
ureteral tumors. During the years 1989 to 1998, 16 patients were diagnosed
as having ureteral tumors. These patients were referred for sonographic
examination for evaluation of hematuria (seven patients) or flank pain
(four patients) or for follow-up screening in patients who were
asymptomatic but at high risk for transitional cell carcinoma because of
known past bladder tumor (five patients). Ten of these patients underwent
intravenous urography examination, three patients had retrograde
pyelography, and 11 patients underwent CT scanning. Ultrasonography
revealed the ureteral tumors in all 16 patients, which appeared as
hypoechoic intraluminal soft tissue. Three tumors were localized in the
upper ureter, four in the middle ureter, and nine in the distal ureter. The
degree of ureterohydronephrosis was minimal (two cases), mild (five cases),
moderate (eight cases), or severe (one case). Eleven tumors caused local
widening of the ureteral diameter. On intravenous urography, four patients
had a nonfunctioning kidney, three patients had unexplained
ureterohydronephrosis, and three patients showed ureteral filling defects,
of which only two had irregular contours. On retrograde pyelography, two
patients had filling defects (one of which with smooth margins), and one
had a truncated ureter. On CT the tumor was clearly demonstrated in only
seven patients. We found that ultrasonography can be a useful diagnostic
tool in the workup of ureteral tumors.
