The authors report a rare congenital anomaly, retrocaval ureter (RCU) with carcinoma. The patient had recurrent pyelonephritis, hematuria and renal colic. Urography shows no function on right side. Abdominal ultrasound revealed marked right hydronephrosis. Antegrade ureterography through nephrostomy revealed a RCU. Helical C.T. confirmed the RCU and also revealed a defect in contrast medium in the upper ureter. We performed percutaneus antegrade nephro-ureteroscopy and found carcinoma of the retrocaval ureter. This may be the first case of tumor in the RCU. We did not find any other in the literature. (Fig. 3, Ref. 14.).
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Retrocaval ureter: a case report and review of the literature.
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Department of Surgery, School of Clinical Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Background: The retrocaval ureter is a rare congenital anomaly resulting from abnormal development of the inferior vena cava. The obstruction is usually at the retrocaval segment of the ureter, as it lies between the inferior vena cava and the body of the third lumbar vertebra. Computed tomography intravenous urography is the gold standard for investigating this condition and can reveal ipsilateral hydronephrosis and the fishhook sign or sickle sign of the proximal ureter, depending on the type of retrocaval ureter.
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Retrocaval ureter is a rare congenital anomaly. It usually occurs on the right side and cases on the left side without accompanying conditions such as situs inversus or double inferior vena cava (IVC) are uncommon. Instances of left retrocaval ureter without situs inversus or double IVC are rarely reported in the literature, and there are no cases presented sonographically.
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