Papillary ureteral neoplasm of low malignant potential in the upper urinary tract: endoscopic treatment

Clin Genitourin Cancer. 2014 Dec;12(6):451-4. doi: 10.1016/j.clgc.2014.04.006. Epub 2014 Jun 10.


Introduction: Papillary ureteral neoplasm of low malignant potential (PUNLMP) is a rare diagnosis, and to our knowledge, has not yet been reported in the upper urinary tract. In this study, we aimed to present our experience in managing a very rare diagnosis, PUNLMP, in the upper urinary tract, with endoscopic treatment.

Materials and methods: Files of patients who received surgery between January 2007 and January 2013 for upper urinary tract tumors were reviewed and patients treated for PUNLMP in the upper urinary tract in 4 urology clinics were reviewed. Patients included in the study had at most 2 tumors in the ureter and had a pathology of PUNLMP.

Results: The study included 11 patients with a mean age of 58.5 years. There were 9 men, and 2 women with a smoking rate of 81.8%. Nine patients (8 in the distal and 1 in the mid ureter) were managed using a semirigid ureteroscope. Two patients (1 with mid ureteral and 1 proximal) were treated using flexible ureteroscopy. The mean hospital stay was 1.56 days. Mean surgical time was 37.18 ± 7.14 minutes. The mean follow-up was 31.5 (range, 7-72) months. In the follow-ups, 3 patients had recurrences of 3, 2, and 4 mm in 9, 15, and 17 months, respectively.

Conclusion: For tumors with a low risk of progression and relatively low risk of recurrence, organ-sparing treatments should be the choice of preference. To support our initial findings, randomized controlled studies on larger cohorts should be designed.

Keywords: Carcinoma; Endoscopy; PUNLMP; Tumor; Ureter.

MeSH terms

  • Adult
  • Carcinoma, Papillary / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Ureteral Neoplasms / surgery*
  • Ureteroscopy / methods*