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Case Report
A rare case of isolated lower ureteric tuberculosis mimicking a ureteric tumor
1 Consultant Urologist and Assistant Professor, Department of Surgery, SMBT IMSRC, Dhamangaon, Ghoti, Igatpuri, Nashik, Maharashtra, India
2 Consultant Urologist, Department of Surgery, SMBT IMSRC, Dhamangaon, Ghoti, Igatpuri, Nashik, Maharashtra, India
3 Associate Professor, Department of Pathology, SMBT IMSRC, Dhamangaon, Ghoti, Igatpuri, Nashik, Maharashtra, India
4 Resident Medical Officer, Department of Surgery, SMBT IMSRC, Dhamangaon, Ghoti, Igatpuri, Nashik, Maharashtra, India
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Sanjay P Dhangar
Urologist and Assistant Professor, Department of General Surgery, SMBT Institute of Medical Sciences & Research Center, Nandi Hills, Dhamangaon, Ghoti, Igatpuri, Nashik, Maharashtra 422403,
India
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Article ID: 100012Z15SD2021
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Dhangar SP, Syed AA, Khadatkar A, Shengal M. A rare case of isolated lower ureteric tuberculosis mimicking a ureteric tumor. J Case Rep Images Urol 2021;6:100012Z15SD2021.ABSTRACT
Introduction: Tuberculosis (TB) is among the top ten leading cause of death resulting from a single infectious cause worldwide. Genitourinary tuberculosis (GUTB) accounts for 20–40% of extrapulmonary tuberculosis (EPTB) cases. It is the second most common site in developing nations and third most common site in developed countries. The diagnosis of GUTB should be considered in a patient presenting with vague long-standing urinary symptoms and the cause has not been identified or is unknown. It has a very varied presentation that leads to a delay in diagnosis. It may present as infertility, renal failure, or disseminated disease. So, high index of suspicion is needed for early diagnosis and prompt treatment. The presenting complaints could be loin/flank pain or it could be dysuria, increased frequency of urine, hematuria, renal or ureteric colic, scrotal pain and swelling, primary or secondary infertility, and ulceration or fistula in the genital area. Isolated TB of ureter is rare. We here present a case of lower ureteric TB that mimicked a tumor in most of the aspects and will let you know how the patient was saved form undergoing a major surgery.
Case Report: A 28-year-old male presented to us with complaint of dull and intermittent left flank pain with one episode of hematuria for past six months. No significant past history was found. Blood investigation was normal. Urine showed microscopic hematuria. Ultrasonography of abdomen suggested left hydronephrosis and hydroureter. Computed tomography suggested left lower ureteric tumor with ureteric wall thickness of 6 mm with periureteric fat stranding and enhancement of ureteric wall after intravenous contrast. There was no enhancement of the tumor post contrast. Cystoscopy revealed normal bladder and a tumorous mass extension from left ureteric orifice. We took a biopsy from the mass. Biopsy report showed abundant caseating necrosis with multi-nucleated giant cell formation suggestive of TB. He was then started on anti-tubercular treatment and recovered well.
Conclusion: Isolated ureteric TB is rare. It may present as pseudotumor of the ureter.
Keywords: CT features of ureteric tuberculosis, GUTB, Isolated ureteric tuberculosis, Pseudotumor of ureter
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Author Contributions
Sanjay P Dhangar - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Avais A Syed - Conception of the work, Design of the work, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Ashwini Khadatkar - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Manisha Shengal - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Sanjay P Dhangar et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
