Frequency and etiology of unexplained bilateral hydronephrosis in patients with breast cancer: results of a longitudinal CT study

Published:November 21, 2011DOI:


      We retrospectively reviewed the records of 153 patients with breast cancer undergoing serial abdominal computed tomography (CT). During a median follow-up of 40 months, 2 (1.4%) of 153 patients developed bilateral hydronephrosis in the absence of radiologically visible obstructing pathology. Surgery confirmed malignant infiltration of the ureters by metastatic lobular carcinoma in both patients, suggesting that new unexplained bilateral hydronephrosis on serial CT in patients with breast cancer is likely to reflect infiltrative retroperitoneal involvement of the ureters by metastatic lobular carcinoma.


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        • Abeloff MD
        • Wolff AC
        • Weber BL
        • et al.
        Cancer of the breast.
        in: Abeloff MD Abeloff: Abeloff's clinical oncology. 4th ed. Elsevier, Maryland Heights2008
        • Borst MJ
        • Ingold JA
        Metastatic patterns of invasive lobular versus invasive ductal carcinoma of the breast.
        Surgery. 1993; 114 ([discussion 641--2]): 637-641
        • Sastre-Garau X
        • Jouve M
        • Asselain B
        • et al.
        Infiltrating lobular carcinoma of the breast. Clinicopathologic analysis of 975 cases with reference to data on conservative therapy and metastatic patterns.
        Cancer. 1996; 77: 113-120
        • Lee YT
        Breast carcinoma: pattern of metastasis at autopsy.
        J Surg Oncol. 1983; 23: 175-180
        • Winston CB
        • Hadar O
        • Teitcher JB
        • et al.
        Metastatic lobular carcinoma of the breast: patterns of spread in the chest, abdomen, and pelvis on CT.
        AJR Am J Roentgenol. 2000; 175: 795-800
        • Caskey CI
        • Scatarige JC
        • Fishman EK
        Distribution of metastases in breast carcinoma: CT evaluation of the abdomen.
        Clin Imaging. 1991; 15: 166-171
        • Harake MD
        • Maxwell AJ
        • Sukumar SA
        Primary and metastatic lobular carcinoma of the breast.
        Clin Radiol. 2001; 56: 621-630
        • Grabstald H
        • Kaufman R
        Hydronephrosis secondary to ureteral obstruction by metastatic breast cancer.
        J Urol. 1969; 102: 569-576
        • Grabstald H
        • Sherman RS
        Radiographic diagnosis of ureteral involvement by metastatic breast cancer.
        Radiology. 1969; 92: 1184-1187
        • Geller SA
        • Lin C
        Ureteral obstruction from metastatic breast carcinoma.
        Arch Pathol. 1975; 99: 476-478
        • Akmal M
        • Kaptein EM
        • Bertram J
        • et al.
        Acute renal failure due to bilateral ureteral obstruction by metastases from breast cancer.
        Nephron. 1986; 42: 23-28
        • Recloux P
        • Weiser M
        • Piccart M
        • et al.
        Ureteral obstruction in patients with breast cancer.
        Cancer. 1988; 61: 1904-1907
        • Oldford JR
        • Lim K
        Ureteral obstruction secondary to metastatic breast carcinoma: report of a case.
        J Am Osteopath Assoc. 1983; 82: 601-604
        • Yousef GM
        • Gabril MY
        • Al-Haddad S
        • et al.
        Invasive lobular carcinoma of the breast presenting as retroperitoneal fibrosis: a case report.
        J Med Case Reports. 2010; 4: 175
        • Krakora GA
        • Coakley FV
        • Williams G
        • et al.
        Small hypoattenuating hepatic lesions at contrast-enhanced CT: prognostic importance in patients with breast cancer.
        Radiology. 2004; 233: 667-673
        • Brinton: Quoted by McGlannan A
        Linitis plastica hypertrophica (leather bottle stomach).
        JAMA. 1916; LXVI: 92-94
        • Howard C
        Linitis plastica: a study of ten cases.
        Q J Med. 1933; 2: 59-78
        • Rudralingam V
        • Dobson MJ
        • Pitt M
        • et al.
        MR imaging of linitis plastica of the rectum.
        AJR Am J Roentgenol. 2003; 181: 428-430
        • Levine MS
        • Pantongrag-Brown L
        • Aguilera NS
        • et al.
        Non-Hodgkin lymphoma of the stomach: a cause of linitis plastica.
        Radiology. 1996; 201: 375-378
        • Arpino G
        • Bardou VJ
        • Clark GM
        • et al.
        Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome.
        Breast Cancer Res. 2004; 6: R149-156
        • Feun LG
        • Drelichman A
        • Singhakowinta A
        • et al.
        Ureteral obstruction secondary to metastatic breast carcinoma.
        Cancer. 1979; 44: 1164-1171
        • Harris M
        • Howell A
        • Chrissohou M
        • et al.
        A comparison of the metastatic pattern of infiltrating lobular carcinoma and infiltrating duct carcinoma of the breast.
        Br J Cancer. 1984; 50: 23-30
        • Lamovec J
        • Bracko M
        Metastatic pattern of infiltrating lobular carcinoma of the breast: an autopsy study.
        J Surg Oncol. 1991; 48: 28-33
        • Merino MJ
        • Livolsi VA
        Signet ring carcinoma of the female breast: a clinicopathologic analysis of 24 cases.
        Cancer. 1981; 48: 1830-1837