Adenocarcinoma following urinary diversion

Abstract

The use of bowel segments in urinary diversions has been associated with an increased risk of neoplasia. This report describes three cases of intestinal adenocarcinoma following urinary diversion. In the first case, a 73-year-old woman developed moderately-differentiated colonic adenocarcinoma in her Indiana pouch 10.5 years after cystectomy. The second case involved a 77-year-old man with well-differentiated adenocarcinoma in his Indiana pouch 9 years after radical cystoprostatectomy and en bloc urethrectomy. The third case involved a 38-year-old man with moderately-differentiated adenocarcinoma arising in his ileal conduit 33 years after the creation of the conduit. These cases highlight the diagnostic signs of adenocarcinoma arising in urinary diversions and emphasize the importance of lifelong surveillance in these patients.

Cancer of the Indiana Pouch: A Case Report and Review of the Literature

“…Ten published articles with a pathologic diagnosis of adenoma or carcinoma of the Indiana pouch were identified in our search interval from December 1996 to April 2012. [6][7][8][9][10][11][12][13][14][15] Data were gathered and tabulated regarding the following 12 variables: age, sex, primary malignancy, latency period, stone formation, tumor size, tumor site, signs and symptoms, tumor pathology, presence or absence of metastatic disease, therapy, and outcomes.…”

“…At present, 10 cases of malignancies originating in an Indiana pouch have been reported (Table 1). [6][7][8][9][10][11][12][13][14][15] We report an 80-year-old patient who presented with metastatic adenocarcinoma of the Indiana pouch, and was treated with palliative systemic chemotherapy. To our knowledge, this is the first reported case that presented with widespread metastatic disease, and was managed with palliative chemotherapy.…”

Managing noninvasive recurrences after definitive treatment for muscle-invasive bladder cancer or high-grade upper tract urothelial carcinoma

“…Usually occurring between 2 and 16 years postoperatively, adenocarcinoma is the most common neoplastic disease of urinary conduits and neobladders [27]. Still, there are reports of urothelial carcinoma recurrence within created urinary diversions, the majority of which will occur at the urethral or uretero-enteric anastomosis [28 & ].…”