Ureteral cancer (ureteral carcinoma)

Ureteral cancer, medically known as urothelial carcinoma, is a malignant tumor that affects the lining of the ureter—the connecting passage between the kidney and the bladder. This form of cancer is considered an upper urinary tract tumor and occurs significantly less frequently than bladder cancer.

Risk factors include:

• Smoking – the most common known trigger
• Chronic irritation of the urinary tract, such as kidney stones or infections
• Contact with certain chemicals (e.g., industrial chemicals)
• Family predisposition or genetic syndromes (e.g., Lynch syndrome)

Early stages are often asymptomatic. Initial signs may include:

• Blood in the urine (hematuria) – painless but visible or only under a microscope
• Flank pain due to urinary retention
• Frequent urination or burning during urination
• General symptoms such as fatigue or weight loss in advanced stages of the disease

• Urine examination (cytology): Detection of tumor cells
• Imaging: CT urography or MRI urography to visualize the ureters
• Ureteroscopy (examination of the ureter): Direct view of tumors, tissue samples possible
• Cystoscopy, as the bladder is often also affected

Treatment depends on the location, size, and spread of the tumor, as well as the patient's general health.

Possible treatment options include:

• Surgical removal of the affected ureter along with portions of the kidney (nephroureterectomy)
• Partial resection for small, localized tumors
• Ureter-preserving procedures in selected patients
• Systemic therapy (e.g., chemotherapy), especially in advanced disease
• Regular follow-up to detect relapses early