Metastatic Malignant, Functional, Post‐renal Anuria

SUMMARY Three examples of metastatic malignant, functional, post‐renal anuria are presented. They occurred in patients with tumours of the breast, stomach, and pancreas respectively. In all there was widespread metastatic malignant infiltration of the retroperitoneal tissue, particularly in the region of the ureters. Mechanical obstruction of the ureters was excluded during life by the free passage of retrograde ureteric catheters and at autopsy by the passage of probes. Iliac and para‐aortic lymph node metastases were present but were not responsible for the ureteric obstruction. The aetiology of the post‐renal oliguria and anuria was obscure, but previous studies by other writers suggest that ureteric peristalsis was impaired by the presence of ureteric or peri‐ureteric infiltration. An analogy is drawn between the functional effects produced by metastatic malignant retroperitoneal infiltration and idiopathic retroperitoneal fibrosis: differential diagnosis may require surgical exploration and biopsy of the peri‐ureteric tissues or a portion of the ureter itself.