Malignant tumors
Urothelial carcinomas

Author: Sean Williamson, M.D. (see Authors page)

Revised: 11 September 2017, last major update June 2012

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: urothelial carcinomas [title] "loattrfree full text"[sb]

Cite this page: Williamson, S. Urothelial carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/uretersurothelialcar.html. Accessed July 21st, 2018.
Definition / general
  • Urothelial carcinoma of renal pelvis and ureter often lumped together as "upper urinary tract"
  • Most malignancies of ureter are urothelial carcinomas
  • Most patients are women, age 50+, nonwhite
  • Cause obstruction, may be multiple, occur concurrently in lower urinary tract
  • Associated with smoking, occupational exposure to arylamines, analgesic nephropathy, Balkan nephropathy
  • Also associated with hereditary nonpolyposis colorectal cancer syndrome (HNPCC / Lynch syndrome, with mutations in DNA mismatch repair genes, detectable by microsatellite instability including MLH1, MSH2, MSH6, and PMS2); in contrast, bladder urothelial carcinoma is not clearly associated with HNPCC
  • Associated with family history of colon cancer and higher grade urothelial carcinomas (Mod Pathol 2002;15:790)
  • Overall 5 year survival (including renal pelvis) is 75%
  • Tumor grade and stage are most important predictors of prognosis
  • Low grade, noninvasive papillary urothelial carcinomas are monoclonal; multiple synchronous tumors appear to be due to intramucosal seeding (Hum Pathol 1999;30:1197)
Case reports
  • Nephroureterectomy with excision of ipsilateral ureteral orifice and bladder cuff en bloc
Gross images

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Bulbous expansion of proximal ureter

Exophytic mass

Microscopic (histologic) images

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Various images


AE1 / AE3

Lymphoepithelioma-like carcinoma

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Various images of micropapillary variant of urothelial carcinoma

Urothelial papillary carcinoma

Various images

Positive stains
Molecular / cytogenetics images

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Microsatellite analysis