Advanced ureteral carcinoma with supraclavicular mass: LONG-term survival after multimodality treatment a case report

A 55-year-old woman visited our institution because of a left supraclavicular mass noted two months earlier. Biopsy of the supraclavicular lymph nodes revealed metastasis of urothelial carcinoma CT scan showed marked left hydronephrosis, left ureteral tumor and multiple paraaortic lymph node swelling. With a diagnosis of left ureteral cancer with paraaortic lymph node and left supraclavicular lymph node metastases, radical surgery (left nephroureterectomy + pelvic and paraaortic lymph node dissection + left cervical lymph node dissection) was performed following three courses of combination chemotherapy (MEC ; Methotrexate 30 mg/m², Epirubicin 50 mg/m ², Cisplatin 100 mg/m²). Histopathologically, cancer cells were still present within the ureteral tumor, but no viable cells were observed in any of the lymph nodes. Three months postoperatively, left cervical lymph node swelling was found. This was resected and histopathologically confirmed as recurrence. Adjuvant chemotherapy was administered (MEC), but this was stopped because of grade 4 thrombocytopenia Five months later, another cervical lymph node recurrence was resected, followed by 50 Gy of external beam irradiation to the left cervical area Following irradiation, no evidence of recurrence has been found during a period of 8 years.