Advanced Renal Pelvic Tumor Diagnosed after Resection of a Solitary Subcutaneous Metastasis: A Case Report

A 75-year-old woman had suffered from intermittent gross hematuria. Ultrasonography, enhanced CT, cystoscopy and urinary cytology had no abnormal findings. Four months later, antibiotics were administered for recurrent gross hematuria and urinary frequency, and not effective. Then, a subcutaneous masson her buttock wasfound to be rapidly growing. The tumor waspathologically diagnosed asan adenocarcinoma by surgical resection. One month later, she had lower abdominal pain and the enhanced CT examination revealed right renal pelvic tumor. Laparoscopic nephroureterectomy was performed and the pathological diagnosiswaspoorly differentiated urothelial carcinoma with adenocarcinoma differentiation. Under the immunohistochemical analyses, the patient was diagnosed with renal pelvic tumor with subcutaneous metastasis. Chemotherapy was not effective for the rapid metastasis throughout the body, and the patient died 4 monthsafter the surgery.