Urothelium is a highly specific epithelial membrane of the urinary tract that covers the renal pelvis, ureters, bladder and urethra. Malignant transformation of urothelium leads to the development of urothelial carcinoma. Urothelial cancer ranks 4th in the prevalence of malignant tumors after prostate cancer (or breast), lung and colorectal cancer. This type of tumor can occur in the lower urinary tract (bladder or urethra), and in the upper (Cup-pelvic system of the kidney or ureter). Bladder cancer is 90-95% of all cases of urothelial cancer. Urothelial cancer of the upper urinary tract is quite rare and accounts for 5-10% of all cases of urothelial cancer. The similarities of these tumors can be used in their diagnosis of the same research methods. And the differences make it necessary to consider separately the methods of treatment and prognosis of the disease . We present a rare clinical case of diagnosis and treatment for 4 years of metachronous urothelial bladder cancer and both ureters. The patient G., 45 years old, was treated in the Department of urology of the national medical research center of surgery. A.V. Vishnevsky" Ministry of health of in the period from 2013 to 2017 with a diagnosis: Metachronous multiple primary cancer: bladder Cancer III. рТ1N0М0. Transurethral resection of the bladder (2) 2011-13. Intravesical chemotherapy with Mitomycin 40 mg 4 course. Resection of the bladder 2013. Second-wrinkled bladder. Relapse. Cancer of the right ureter I art. pt1n0m0. Cancer of the left ureter I art. pt1n0m0. In 2011, the patient began to observe an admixture of blood in the urine. Turned to the urologist at the place of residence, cystoscopy was performed. The audit revealed papillary exophytic tumors of the posterior bladder wall. In the Department of urology of the Lipetsk Oncology center, transurethral resections of the bladder were repeatedly performed (August 2011, March 2012), intravesical chemotherapy with Mitomycin (4 courses of 40 mg). In April 2013, on the occasion of the recurrence produced by open resection of the bladder. The postoperative period was complicated by the formation of the urinary fistula of the anterior abdominal wall. 08.04.2013 g. made an audit of the bladder, bladder biopsy, excision of the fistula. Upon delivery of the diagnosis bladder cancer, and with constant recurrence especially, you must be unconstrained in relation to the upper urinary tract. Timely detection of muscle-invasive and / or common superficial urothelial cancer is crucial, as delay in diagnosis and therapy can be life-threatening. With recurrent bladder cancer, it is necessary to be wary cancerin relation to the upper urinary tract.
Authors declare lack of the possible conflicts of interests.