Adenocarcinoma arising at the ileoileal anastomotic site of Scheele's ring

Yokoyama, Minato; Fujii, Yasuhisa; Okuno, Tatsusada; Kawakami, Satoru; Kobayashi, Tsuyoshi; Masuda, Hitoshi; Kageyama, Yukio; Kihara, Kazunori

doi:10.1046/j.1442-2042.2003.00667.x

Cited by 9 publications

(2 citation statements)

References 7 publications

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“…Interestingly, the same situation occurs in patients following ureterosigmoidostomy where most adenocarcinomas developed at the site of the anastomosis [ 1 , 3 ]. Additionally, though spontaneous ileal malignancies are very rare, ileal malignancies have been more frequently reported at the site of surgical anastomosis such as ileo-ileostomy [ 23 ]. The inflammatory response hypothesis has been suggested as accounting for the increased susceptibility of development of tumors at the line of anastomosis between the intestinal segment and native bladder, but the supporting evidence is inconclusive and the exact mechanism is not well understood [ 1 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Tubular adenoma with high-grade dysplasia in the ileal segment 34 years after augmentation ileocystoplasty: report of a first case

2007

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Neoplasms of the urinary bladder following augmentation ileocystoplasty are rare. We present the case of a 39-year-old male with a tubular adenoma with high-grade dysplasia in the ileal segment 34 years after augmentation ileocystoplasty to enlarge a post-chemoradiation-induced shrunken bladder. He presented with gross hematuria. Cystoscopy revealed a papillary tumor at the site of ileovesical anastomosis, and transurethral resection was performed. Histologic examination revealed a tubular adenoma with high-grade dysplasia. There are only two previous reports of tubulovillous adenoma in ileal segment after ileocystoplasty, both without high-grade dysplasia. Our observation supports the hypothesis that an ileal neobladder may undergo all the morphologic and molecular changes observed in the development of gastrointestinal adenocarcinoma. Therefore, patients who had an ileal neobladder created should be closely followed.

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Section: Discussionmentioning

confidence: 99%

Tubular adenoma with high-grade dysplasia in the ileal segment 34 years after augmentation ileocystoplasty: report of a first case

2007

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“…Immunohistochemical analysis revealed a loss of uroplakins and cytokeratins 7, 14, and 19 (characteristic of urothelium) concomitant with the differentiation of mucin secreting glandular structures containing Periodic Acid‐Schiff (PAS)‐positive goblet cells (Li et al, 2000). These findings have relevance to the anastomotic site of intestinal‐bladder augmentations and internal urinary diversions in which urothelium is in direct contact with the gastro‐intestinal tract tissues and where the incidence of malignant growth is elevated (Young and Parkhurst, 1984; Yokoyama et al, 2003).…”

Section: Plasticity Of Urothelial Differentiationmentioning

confidence: 96%

Molecular, cellular and developmental biology of urothelium as a basis of bladder regeneration

et al. 2005

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Tumour formation within intestinal segments transposed to the urinary tract

Pickard

2004

World J Urol

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Patients and their urologists are quite rightly concerned about the possibility of neoplastic change within intestinal segments transposed to the lower urinary tract. This fear arises from the occurrence of latent adenocarcinoma arising from the urocolic anastomosis in approximately 10% of patients who underwent ureterosigmoidostomy in childhood. The present text provides an update of previous reviews and details work published since 1990 on epidemiological, experimental and clinical studies. Consideration of the collected evidence confirms the increased risk of colonic neoplasia following mixing of the faecal and urinary stream by ureterosigmoidostomy or its more recent variants. In contrast, the occurrence of tumours within transposed intestinal segments appears more likely to be related to the underlying urinary tract disease for which the surgery was performed rather than exposure of the intestinal mucosa to urine. This conclusion is, however, based on low level evidence and, despite the reassuring findings, caution is advised until more robust data are available to provide a confident risk assessment.

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Adenocarcinoma arising at the ileoileal anastomotic site of Scheele's ring

Cited by 9 publications

References 7 publications

Tubular adenoma with high-grade dysplasia in the ileal segment 34 years after augmentation ileocystoplasty: report of a first case

Tubular adenoma with high-grade dysplasia in the ileal segment 34 years after augmentation ileocystoplasty: report of a first case

Molecular, cellular and developmental biology of urothelium as a basis of bladder regeneration

Tumour formation within intestinal segments transposed to the urinary tract

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