[A case of primary squamous cell carcinoma of the ureter: biochemical modulation with cisplatin and 5-fluorouracil].

A case of primary squamous cell carcinoma of the ureter is reported. A 62-year-old male presented with gross hematuria and paralysis of the left leg. Abdominal computed tomographic (CT) scan and ultrasonography revealed left hydronephrosis, a massive tumor (8 x 7 cm) in the left distal ureter which invaded the pelvic bone (T4), and left obturator lymph node metastasis (N2). Pathologic examination of the biopsy specimen revealed poorly differentiated squamous cell carcinoma. Cisplatin (100 mg/m2, day 1) and 5-fluorouracil (960 mg/m2/day, days 2-6) were administered systemically in accordance with biochemical modulation regimen for head and neck squamous cell carcinoma, and a minor response was obtained (tumor regression rate 38%, serum SCC antigen regression rate 64%). Thereafter, resection of residual tumor was performed, resulting in noncurative operation because of direct invasion to the pelvic bone. Four months after tumorectomy, liver metastasis appeared, and the patient died of disease 14 months after the initial visit. Combination therapy with cisplatin and 5-fluorouracil is widely used for head and neck squamous cell carcinoma, and the response rate has been reported to be 46-94%. This regimen may also be effective against urological squamous cell carcinoma.