Locally advanced invasive urothelial cancer of the lower third of the ureter in a high-risk patient
(clinical observation) 

Ali Z. Almyashev, Candidate of medical sciences, associate professor of the sub-department of oncology with a course of radiation diagnostics and radiation therapy, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), almyashev_2005@mail.ru
Nikita Yu. Stepanov, Candidate of medical sciences, oncologist of the department of abdominal oncology, Republican Oncological Dispensary (30 Ulyanova street, Saransk, Russia), uro-stepanov@mail.ru
Pavel I. Skopin, Doctor of medical sciences, professor, head of Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), skopinpi@mail.ru
Artem A. Ivashin, Senior lecturer of the sub-department of oncology with a course of radiation diagnostics and radiation therapy, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), a.iwashin2017@yandex.ru
Irina V. Gorgan, Postgraduate student, assistant of the sub-department of oncology with a course of radiation diagnostics and radiation therapy, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), irina.gorgan@yandex.ru
Aleksandr E. Mayorov, Postgraduate student, assistant of the sub department of oncology with a course of ra diation diagnostics and radiation therapy, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), sasha.mayorow@yandex.ru

Background. Urothelial carcinoma of the upper urinary tract is considered a rare pathology in the practice of a urologist or oncologist. This tumor is quite aggressive in nature: for example, 60% of urothelial cancer cases at the time of diagnosis are represented by invasive forms. The diagnosis is difficult due to the absence of a specific clinical picture - the most common symptom is macro- or microhematuria. The purpose of the study is to provide an example of management tactics for a patient diagnosed with urothelial cancer of the upper urinary tract. Materials and Methods. This article presents our own clinical observation of a 70-year-old patient diagnosed with urothelial cancer of the ureter. Conclusions. The gold standard of treatment of urothelial cancer is radical nephroureterectomy with pelvic lymphodissection on the side of the lesion. Indications for neoadjuvant and ad juvant therapy are determined collegially in each individual case.

urothelial cancer, ureter, radical nephroureterectomy, high-risk patient

Almyashev A.Z., Stepanov N.Yu., Skopin P.I., Ivashin A.A., Gorgan I.V., Mayorov A.E. Locally advanced invasive urothelial cancer of the lower third of the ureter in a high-risk patient (clinical observation). Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskie nauki = University proceedings. Volga region. Medical sciences. 2025;(2):41–50. (In Russ.). doi: 10.21685/2072-3032-2025-2-4