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Malignant Neoplasm of the Renal Pelvis and Ureter B044

Document
Last amended 
14 October 2019
Current RMA Instruments
Reasonable Hypothesis SOP

92 of 2019 

Balance of Probabilities SOP93 of 2019 
Changes from previous Instruments

SOP bulletin 211

ICD Coding
  • ICD-9-CM Codes: 189.1,189.2
  • CD-10-AM Codes: C65, C66, C07
Brief description

This is a primary cancer of the renal pelvis (the structure that collects urine from the kidney and funnels it into the ureter), or the ureter (the tube that connects the kidney to the bladder). 

Confirming the diagnosis

The diagnosis requires confirmation by histology.

The relevant medical specialist is a urologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the renal calyx, renal pelvis, pelviureteric junction or ureter
  • Neuroendocrine carcinoma (including malignant carcinoid) of the renal calyx, renal pelvis, pelviureteric junction or ureter
  • Squamous cell carcinoma of the renal calyx, renal pelvis, pelviureteric junction or ureter
  • Carcinoma in situ of the renal calyx, renal pelvis, pelviureteric junction or ureter
  • Carcinoma of the renal calyx, renal pelvis, pelviureteric junction or ureter
  • Transitional cell carcinoma of the renal calyx, renal pelvis, pelviureteric junction or ureter
Related conditions that may be covered by SOP (further information required)
  • Cancer of the renal pelvis, renal calyx or ureter
  • Renal pelvic and ureteric cancer
Conditions not covered by SOP
  • Hodgkin’s lymphoma of the renal calyx, pelvis or ureter* 
  • Malignant neoplasm of ureteric orifice of bladder* (malignant neoplasm of the bladder SOP)
  • Non-Hodgkin lymphoma of the renal calyx, pelvis or ureter*
  • Secondary/metastatic cancer involving the renal calyx, pelvis or ureter (code to primary site)
  • Soft-tissue sarcoma of the renal calyx, pelvis or ureter*

* another SOP applies

Clinical onset

The most common presentation is with haematuria (blood in the urine).  Flank pain may also occur.  Clinical onset will often be based on the first relevant symptoms.  The condition may also be found incidentally, e.g., following radiological imaging or cystoscopy with ureteropyeloscopy for investigation of a bladder condition.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition has a variable course and prognosis.  It is amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.