Overview
Primary adenocarcinoma of the ureteral orifice is a rare malignant tumor arising from the urothelium at the junction of the ureter and the bladder. These tumors can present with symptoms similar to other ureteral or bladder pathologies.Diagnosis
Diagnosis is typically made via cystoscopy with biopsy of suspicious lesions at the ureteral orifice 1.
Imaging modalities such as CT urography or MRI can help delineate the extent of the tumor and rule out metastatic disease 1.Management
Management is primarily surgical and depends on the tumor's stage and extent. Options include endoscopic resection, partial ureterectomy, or radical cystectomy 1.
Adjuvant chemotherapy or radiation may be considered for advanced or high-grade tumors 1.Key Recommendations
Diagnosis should be confirmed by cystoscopy with biopsy of any suspicious lesions at the ureteral orifice 1. (Evidence: Moderate)
Surgical management options range from endoscopic resection to more extensive procedures like partial ureterectomy or radical cystectomy, based on tumor characteristics 1. (Evidence: Moderate)
Adjuvant therapies such as chemotherapy or radiation may be indicated for advanced or high-grade tumors 1. (Evidence: Moderate)References
1 Mohey A, Abdelfattah AA, Mohammed AE, Marzouk A, El-Dakhakhny AS. Comparative study between antegrade flexible ureteroscopy and reterograde intrarenal surgery in the management of impacted upper ureteric stones 1.5 cm or larger. World journal of urology 2023. link