Epidermoid Cyst of the Ureter Mimicking Recurrent Urothelial Carcinoma: A Case Report and Brief Literature Review.
Omar M Halalsheh, Atef F Hulliel, Abdallah Abualasal et al.
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Case in brief
A 79-year-old man with a history of high-grade papillary urothelial carcinoma presented with a proximal right ureteral filling defect on CT scan, raising suspicion for tumor recurrence. Flexible ureteroscopy and excision revealed a keratinizing squamous-lined cyst, confirmed as a benign epidermoid cyst through histopathology and immunohistochemistry, allowing for minimally invasive management without radical surgery.
What made this case unusual
Epidermoid cysts in the urinary tract are exceptionally rare, and this case illustrates their potential to mimic malignancy in patients with a history of urothelial carcinoma.
Diagnostic / clinical pearl
Imaging findings of ureteral filling defects in patients with a history of malignancy may not always indicate recurrence; histopathological evaluation is crucial for accurate diagnosis.
Why it matters
This case emphasizes the need to consider benign conditions like epidermoid cysts in the differential diagnosis of ureteral lesions during oncologic follow-up, potentially preventing overtreatment.