A patient with synchronous bilateral low-grade upper tract urothelial carcinoma who underwent nephroureterectomy and total ureterectomy with ileal ureteric replacement.

We present the case of a synchronous bilateral low-grade upper-tract urothelial carcinoma patient who underwent left nephroureterectomy and right total ureterectomy with ileal ureteric replacement resulting in a favorable prognosis. A 66-year-old male presented with bilateral hydronephrosis. Computed tomography revealed left pelvic and right upper-middle ureteral tumors with no lymph node swelling or distant metastasis. The patient underwent a left nephroureterectomy with a bladder cuff, and histopathology revealed a low-grade urothelial carcinoma. Considering the contralateral low-grade nature as revealed in histopathology and the right retrograde ureterography being noninvasive, he underwent a right total ureterectomy with ileal ureteric replacement. Histopathology of the right ureter revealed a low-grade urothelial carcinoma. The patient successfully avoided an anephric status without renal function deterioration for 4 years with a transurethral resection for a recurrent small papillary bladder tumor on 18 months after the total ureterectomy. © The Japan Society of Clinical Oncology 2020.