[Case report of primary carcinoma in situ in upper urinary tract and review of the Japanese literature].

A case of carcinoma in situ (CIS) in the right renal pelvis in a 71-year-old women is reported. The patient was admitted because of macroscopic hematuria. Drip infusion pyelography showed a filling defect (coagulum) in the right renal pelvis. Other abnormal findings were not made. Malignancy was suspected by cytology examination in both voiding urine and that obtained by catheter from the right pelvis. A right total nephroureterectomy was performed. Macroscopic abnormal findings were only of the coagulum in the renal pelvis. Pathologic examination showed CIS in the renal pelvis. We studied the features, pattern of recurrence, and prognosis of 19 cases of primary CIS in the upper urinary tract in the Japanese literature. A slight higher frequency was reported for women than for men. When the CIS was in the ureter, abnormal roentgenological findings, such as stenosis, filling defects, or a dilated ureter, were common (77%), contrary to expectation. But when the CIS was in the pelvis, such findings were rare. Urine cytology examination was positive in 95% of the patients. In four of the 19 patients, a recurrence was found. In all four patients, the first recurrence was in the bladder within 2 years of surgery. The kind of recurrent bladder tumors varied with the patients. The prognosis with recurrence was poor. If signs of recurrence were not recognized within 2 years of surgery, the prognosis was good.