Three cases of positive cytology of exfoliative urine were studied by endoscopy, IVP and RP, in which no papillary tumors could be detected in renal pelvis, ureter, bladder or urethra, while the random biopsy of bladder mucosa showed no evidence of carcinoma in situ. However, repeated cytology of ureter catheter urine consistantly gave positive results, being suggestive of upper urinary tract CIS. In one case, following left total nephroureterectomy and right total ureterectomy with nephrostomy, histological examination revealed carcinoma in situ in the left renal pelvis and ureter as well as in the right ureter. At 11 months post-operatively, we lost this patient for bronchopneumonia. The 2 other cases are presently being treated with oral anti-cancer agents.
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