Abstract

Primary adenocarcinoma enteric type at ureteropelvic junction is a rare case. The incidence especially at urinary tract only less then 1% of all urinary tract malignancies. A 57 year old woman complained left waist pain since 4 month ago accompanied by fever, dysuria and sometimes pyuria. A plain abdominal imaging revealed a staghorn stone at renal sinistra. Macroscopically, a kidney tissue size 12x6x4cm, ureter length 6cm and diameter 0.7cm, covered with fat. At the incision, firm mass appear at ureteropelvic junction size 3x1,8x1cm with brittle pale yellow substance surround it. Microscopically, shows tumor mass composed by proliferative, anaplastic, columnar epithelial cells, interspersed by goblet cells, forms tubular and villous structure invade into muscularis propria. There’s also distribution of lymphocyte and plasma cells between tumor cells like foam cells infiltrate, epithelioid cells, datia tutos cells with some focal necrosis area. Based on all above, patient diagnosed with adenocarcinoma enteric type, well differentiated (pT2) and chronic xanthogranulomatous pyelonephritis (XGP). The overall prognosis for urinary tract adenocarcinoma is poor and 5 year survaival rate between 40 until 50% generally.

Key words: adenocarcinoma enteric type, chronic xanthogranulomatous pyelonephritis, woman with staghorn stone