Objective: To study the distribution, clinical aspects, management, an
d follow-up of upper urinary tract rumors in general and pelviureteric
transitional cell carcinoma in particular among the total genitourina
ry malignancies managed at our institution. Design: A retrospective an
alytical study of histopathologically confirmed cases of upper urinary
tract tumors managed over fourteen years (Jan.1983 - Dec.1996). Setti
ng: 7th October - University (teaching) Hospital, Benghazi (end point
referral unit for genitourinary cases for North-Eastern Libya). Subjec
t: Records of all the twenty cases of upper urinary tract tumors were
critically evaluated and data collected. Results: The upper urinary tr
act tumors are uncommon comprising only 2.94% (20/680) of all genitour
inary tumors. The incidence of transitional cell carcinoma of upper ur
inary tract was noted to be 5.36% (17/317) among transitional cell car
cinoma of whole urinary tract. These cases were mainly distributed in
6th-7th decades with a male predilection. Frank total hematuria was th
e main clinical presentation (80%). In one patient metastasis to Virch
ow's lymph node was an unusual finding. As two thirds of cases were ha
ving muscle-invasive (high stage/high grade) disease, therefore, the e
xtent of surgical resection alone could not affect the survival and pr
opensity of recurrence to lower urinary tract. However, complete nephr
oureterectomy with removal of bladder mucosal cuff is the only as yet
available therapy for this disease.