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Watch Out for Swelling and Pain of the Lower Left Limb; It Could be Malignant Medullary Carcinoma of the Ureter

       According to Dr. Kuo Chung-he of the Department of Orthopedic Surgery of Taipei City Hospital Zhongxing Branch, recently a 62-year-old man sought medical attention for swollen pain in his lower left limb; however, he was mostly treated for suspected muscle pain, fascia inflammation or edema of the lower limbs. Upon going to the Department of Orthopedic Surgery, the patient had even swelling in the thigh and calf regions of the lower left limbs, which were different from normal lower limb edema and looks more like a blockage of back flow in the blood vessels of the lower limb. However, ultrasound examination did not show any blockage, and both the heart and kidney were functioning normally as well.

       Upon further inquiry into the patient’s medical history, the patient revealed that he had early bladder carcinoma about 10 years ago, and has since recovered after tumor removal and chemotherapeutic perfusion. Moreover, the patient has undergone regular physical examinations, and no tumor relapses were found. Due to the patient’s absence of lower limb blockage and history of cancer, the doctor arranged the patient to undergo a full-body MRI test, and discovered that there is a tumor in the left ureter, which constricted the lymphatic system and resulted in impaired lymphatic back flow, swelling and pain.

       According to Dr. Kuo Chung-he, pain-less hematuria (bloody urine) is a common symptom of carcinoma of the renal pelvis and ureter. The hematuria condition may be intermittent; it could disappear after one incident, or occur again several days or months later. Other symptoms may include recurrent urinary tract infection, waist pain (about 1/3 of patients), weight loss and swelling of the pelvic region. Most importantly, Dr. Kuo reminds everyone to seek medical attention immediately if symptoms such as hematuria or other discomforts occur, and to go to the appropriate department for further examination to identify the issue and receive the most accurate treatment.