Vol. 45 (6): 1266-1269, November – December, 2019
CHALLENGING CLINICAL CASES
Nicholas A. Pickersgill 1, Alec J. Wright 2, Robert S. Figenshau 1
1 Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO, USA; 2 Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
We describe the rare case of a 61-year-old female with right ureteropelvic junction (UPJ) obstruction caused by metastatic cholangiocarcinoma. Her past medical history was notable for cholangiocarcinoma treated with neoadjuvant chemoradiation and two orthotopic liver transplants six years earlier. Urology was consulted when she presented with fl ank pain and urinary tract infection. Diagnostic workup demonstrated right UPJ obstruction. She was managed acutely with percutaneous nephrostomy.
She subsequently underwent robotic pyeloplasty and intrinsic obstruction of the UPJ was discovered. Histological examination revealed adenocarcinoma, consistent with systemic recurrence of the patient’s known cholangiocarcinoma.
Keywords: Ureteropelvic junction obstruction; neoplasm; metastatic; pyeloplasty; cholangiocarcinoma