We present a case of a 67-year-old patient with a history of augmentation ileocystoplasty 31 years ago following genitourinary tuberculosis. Radiological investigations performed due to asymptomatic microscopic haematuria revealed three contrast-enhancing polyps within the neobladder. The patient had enterocystoprostatectomy and histopathological examination of the neobladder revealed mucinous adenocarcinoma in all three polyps, together with a prostatic adenocarcinoma Gleason 7 (3+4). After adjuvant chemotherapy and 1 year of follow-up, he had no sign of clinical or radiological recurrence. Taking into consideration this rare case, we discuss the development of malignant tumours after the incorporation of intestinal segments in a urinary tract reconstruction, showing what relationship exists between secondary neoplastic growth, the primary disease and the type of urinary diversion utilised.

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Highlights Pancreatic angiosarcoma is a rare entity, with 7 cases reported in literature so far. Diagnosis is often difficult, since histology and immunohistochemistry is mandatory. Surgery is the only curative option, though metastatic disease is frequent. Prognosis is very poor for angiosarcomas overall, with a 5-year survival of only 35%.

Objective: This article reports our experience managing neoplasms, stenosis and urolithiasis in patients with anatomical variations of the urinary system, using an endourological approach, either with an antegrade access or with combined access. Patients and methods: A retrospective review was performed using medical records of all patients who underwent percutaneous endourological treatment at our institution between 2014 and 2019. Those with such urinary anatomical variations were selected. Results: Out of 185 patients, 10 were identified. The study group included patients with urinary diversion, renal transplantation and congenital anomalies. Patients were divided into two sets, A and B, based on the presence or absence of urolithiasis, respectively. In set A, the median operative time was 213 minutes (standard deviation ( SD)=65.91 minutes). Only one patient had lithiasis in the first postoperative evaluation. Two patients had postoperative complications graded ⩾II in the Clavien–Dindo classification. Regarding set B, the median operation time was 75 minutes ( SD=66.89 minutes). Two patients had postoperative complications graded ⩾II in the Clavien–Dindo classification. Conclusions: Patients with anatomical tract challenges currently have a longer life expectancy and are therefore prone to urological complications in their unusual structures. Treatment of urological complications is essential, and minimal invasive procedures should be considered to resolve them and to reduce morbidity. Level of evidence: Not applicable.