Rarest cancer to septuagenarian

* Transitional Cell Carcinoma of Ureter to 75-year-old

* 8*5 cm large Tumor found in tests

* KIMS Saveera doctors relieve the patient with laparoscopic surgery

 Anantapur, 10th January 2024: A rare form of cancer known as Transitional Cell Carcinoma of Ureter has an incidence rate of only 2 in one lakh population. Unfortunately, a septuagenarian from Anantapur aged 75 was diagnosed with this cancer.

The patient already had comorbidities like CAPD and CAD. Despite the challenges, the doctors at KIMS Saveera successfully performed a laparoscopic surgery to remove the tumor, along with the right kidney. The team, led by Senior Consultant Renal Transplant Surgeon Dr. G. Durgaprasad and HoD Anesthesia Dr. Ravishankar, achieved this rare feat. Dr. Durgaprasad provided a detailed explanation of the case.

"This type of cancer is mostly found in elderly males around 70 years of age. Aetiological factors like smoking, genetic factors, excessive coffee intake, analgesic abuse, arsenic, people who work in rubber and dye industries, and chronic infection of the ureter are the major causes of this type of cancer. The most common symptoms of these cases are Haematuria, Loin pain, Dysuria, Weight loss, and Loss of appetite.

This 75-year-old man came to our hospital one month ago with the chief complaint of blood in the urine, and right loin pain for 15 days, associated with weight loss and loss of appetite. He consulted local quacks initially, and after many referrals from different hospitals, came to our hospital a bit late.

On evaluation, he was found to have an 8*5 cm large ureteric tumor with gross dilatation of the kidney on the right side filled with blood. We took up this challenging case and planned for a laparoscopic nephro ureterectomy. It took 3 hours to complete the procedure. There were no complications before and after the procedure. The patient was discharged after 4 days in good condition.

Ureter cancer is a very rare condition, which requires a high index of suspicion as per clinical history. We could perform laparoscopic surgery with the help of our eminent anesthesia team and urology team. The kidney was very densely attached to the inferior vena cava, which was very challenging to separate in laparoscopy. This is the second case for us in the last four years.

Previously we have performed open surgery. Now, with the availability of the latest equipment, and technical expertise, we could do this difficult surgery in laparoscopy. Such surgeries were previously restricted only to metro cities. This is the first instance in the Anantapur district" explained Dr. Durgaprasad.