Meningeal Carcinomatosis in a Patient with an Upper Urinary Tract Urothelial Cell Carcinoma

Six months later an intravenous urography showed absence of visualization of the left kidney parenchyma and the ureter. A retrograde pyelography demonstrated a partial obstruction in the proximal third of the left ureter. He underwent ureteroscopy that showed an erythematous lesion not available for biopsy. A sample of urine from selective catheterization of the left ureter showed carcinoma consistent with urothelial carcinoma. A computed tomography (CT) of the thorax and abdomen showed multiple adenopathies in the abdomen and metastasis in the lungs, liver and spine. A bone gammagraphy showed pathological deposits in the left shoulder, ribs, spine and the right pelvis. A biopsy of a liver lesion was positive for urothelial carcinoma.