Primary mucinous adenocarcinoma of the renal pelvis and ureter.

Mucinous adenocarcinomas of the renal pelvis and ureter are among the rarest upper urinary tract neoplasm. We report a case of multifocal primary mucinous adenocarcinoma of the renal pelvis and ureter occurring in association with a staghorn calculus and pyonephrosis. A 68 year old man had suffered from right flank pain and upper abdominal swelling for one year. After a series of investigation, a right staghorn stone with pyonephrosis leading to non-functioning kidney was found. Right nephrectomy was performed. The pathological report showed mucinous adenocarcinoma with ureteric margin positive for tumour deposits. Patient was reoperated; right ureterectomy with removal of bladder cuff was done. Although uncommon, the possibility of a tumor should be kept in mind especially in patients with a long standing urolithiasis accompanied by hydronephrosis and/or infection.