Multifocal pseudosarcomatous tumor of the upper urinary tract

Introduction: Pseudosarcomatous tumors are rarely found in the urogenital t ract. Generally they occur within the bladder. To our knowledge, only one c ase of a manifestation within the upper urinary tract has been reported so far. The benign tumor may mimic a malignancy because of its infiltrative gr owth. No reports are known describing multifocal manifestations or metastas is due to this tumor. Case Report: A 41-year-old otherwise healthy woman presented with sudden on set of macrohematuria. Further diagnostics revealed a tumor in the left dis tal ureter with consecutive hydronephrosis of the left kidney, leaving no f unctional parenchyma. For total tumor-excision, a left nephroureterectomy i ncluding partial resection of the bladder was performed. The pathologist id entified a pseudosarcomatous myofibroblastic multifocal tumor in the left p yelon and in the proximal and distal left ureter. Conclusion: A pseudosarcomatous tumor should always be considered in tumors associated with macrohematuria to avoid unnecessary overtreatment such as radical tumor surgery (cystectomy) or even radiation or chemotherapy. This tumor may also occur within the upper urinary tract. To our knowledge, this represents the first report of a multifocal manifestation. Although pseudo sarcomatous tumors are considered to be benign, follow-ups are recommended, since local recurrences have been reported after incomplete tumor resectio n.