Background:

the urothelial carcinomas originate from the epithelium of mucous revetment of transitional type and constitute almost totality of the tumors of the excretory, high routes. The primary adenocarcinoma of the urinary tract, are extremely infrequent and they usually have an aggressive behavior, with a shaded prognosis.

Objective:

to express the way of presenting a patient with urothelial carcinoma showing some aspects from the sicknesses.

Case report:

a 70-years-old male patient, retired, inveterate smoker and with a history of ingesting coffee in large quantities, attended consultation for gross hematuria, lumbar pain, sometimes fixed, other times in the form of ureteral colic and fever of 39 degrees. The analytical study only showed altered lactic dehydrogenase rate. The imaging study with ultrasound showed hydronephrosis and enlarged right ilium with heterogeneous image of 2 cm in the kidney, at the level of the pelvic ureter junction, which was corroborated by computerized axial tomography. The rest of the examinations such as endoscopy, colonoscopy, and cystoscopy of different regions were all negative. Right nephroureterectomy was performed, and the patient is still asymptomatic.

Conclusions:

the tumors of the upper urothelium are infrequent neoplasias, in the urinary tract an extraurological origin must be ruled out. The differential diagnosis must be made with the renal cell tumor or the bladder tumor.

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