A case report of squamous cell carcinoma in a suprapubic urinary catheter tract: surgical excision and simultaneous colostomy formation

Abstract

Squamous cell carcinoma (SCC) arising from a suprapubic cystostomy tract is a rare complication of long-term suprapubic catheterization (SPC). A 53-year-old man with paraplegia secondary to spina bifida presented with a painful granulomatous lesion around his SPC site that was being treated with silver nitrate cauterization in the community. Consequently, he developed a sacral pressure sore due to reduced mobility from the pain. He also had increasing difficulties with defaecation secondary to his spina bifida. His sacral pressure sore was secondary to a cryptoglandular fistula with coccygeal osteomylelitis. Post-operative pathology revealed infiltrative SCC involving full thickness of the specimen from skin to the bladder wall with clear surgical margins. We describe the first case requiring a simultaneous suprapubic tract SCC excision and colostomy formation. We recommend early investigation of lesions arising from a long-term suprapubic tract especially in patients with spinal cord injuries or congenital defects.

A case of squamous cell carcinoma arising from a suprapubic cystostomy tract in a patient with spinal bifida: Immunohistochemical analysis and literature review

“…Recurrence is usually within a year following treatment. 10 There are only 12 cases reported in the literature, 1 , 2 , 3 , 4 , 10 , 11 , 12 , 13 , 14 , 15 , 16 which are summarized in Table 1 . The treatments used were local excision ( n = 7), radiation ( n = 4), and both local excision and radiation ( n = 1).…”

Malignancies of suprapubic catheter (SPC) tracts in spinal cord injury patients: a case series and review of literature

“…SCI patients account for 50% of cases currently recorded of malignancy affecting the SPC tract, with 22 cases in total being reported. The majority being attributable to SCC (six cases) [17][18][19][20][21][22], followed by adenocarcinoma (three cases) [22,23], a single case of verrucous carcinoma [24], and our case of sarcoma (Table 1).…”

“…Operative planning is essential [20], our first patient presented many challenges. He required pre-operative admission for optimisation due to the incidental finding of a chest infection on the CT scan.…”

“…Reported management favours surgical intervention, a combination of wide local excision, partial or full cystectomy, abdominal wall excision and reconstruction with ileal conduit formation appear to be the treatments of choice [17,20,22,24]. Other courses of management include radiotherapy either as radical or palliative therapy [19,21].…”

“…There have been a small number of recorded cases of malignancy affecting and arising from the SPC tract itself [6][7][8][9][10][11][12][13][14][15][16][17], with a significant proportion of those affected being SCI patients [17][18][19][20][21][22][23][24]. We present three patients affected with malignancy of the SPC tract being; mucinous adenocarcinoma, squamous cell carcinoma (SCC) and sarcoma.…”