Transitional cell carcinoma in orthotopic ileal neobladder 12 years after radical cystectomy

Jovan Hadži-Djokić; Tomislav Pejčić; Vladan Andrejević; Ljubomir Djurašić

doi:10.2298/1549

Jovan Hadži-Djokić Serbian Academy of Sciences and Arts, Belgrade, Serbia
Tomislav Pejčić Urological Clinic, Clinical Center of Serbia, Belgrade, Serbia
Vladan Andrejević Institute of Physical Medicine and Rehabilitation, Clinical Center of Serbia, Belgrade, Serbia
Ljubomir Djurašić Institute of Physical Medicine and Rehabilitation, Clinical Center of Serbia, Belgrade, Serbia

DOI: https://doi.org/10.2298/1549

Keywords: urinary bladder, neoplasms, cystectomy, ileum, colonic pouches, recurrence,

Abstract

Introduction. Some cases of secondary adenocarcinoma developing in the replaced bowel segment of urinary diversions have been reported so far. Secondary adenocarcinoma develops 20 years after surgery in about 0.5% of those in whom an ileal segment is used. There have been several reports in the literature describing extensions of transitional cell carcinoma (TCC) from the distal urether into an ileal conduit. Histology of loop tumor in 50% was TCC. The site of tumors in the majority of cases is the area at the uretheral orifices or the stoma. Case report. We presented a rare case of transitional cell carcinoma in an orthotopic ileal neobladder 12 years after radical cystoprostatectomy and ileal neobladder with the substitution by the procedure Camey II. A 65-year-old man with high-grade urothelial carcinoma of neobladder underwent partial resection of neobladder and right nephroureterectomy. Pathological analysis revealed high-grade urothelial carcinoma to the ileal neobladder (G II, Stage T2b). The patient died of laryngeal cancer a year after the surgery. Conclusion. Surgery of tumors in orthotopic neobladders is possible if diagnosed in time. In the presented case surgery resulted only in a decrease in the capacity of the neobladder without having an effect on the continence itself.

References

Ide H, Kikuchi E, Shinoda K, Mukai M, Murai M. Carcinoma in situ developing in an ileal neobladder. Urology 2007; 69(3): 576.e9−11.

Frese R, Doehn C, Baumgärtel M, Holl-Ulrich K, Jocham D. Carci-noid tumor in an ileal neobladder. J Urol 2001; 165(2): 522−3.

Krupski T, Theodorescu D. Orthotopic neobladder following cys-tectomy: indications, management, and outcomes. J Wound Ostomy Continence Nurs 2001; 28(1): 37−46.

Moore CD, Iczkowski KA, Blue KM, Algood CB. Urothelial carci-noma recurrence in ileal orthotopic neobladder: urethrectomy and creation of ileal conduit. Urology 2007; 69(1): 184.e11−3.

Leandri P, Rossignol G, Gouthier J, Qvintens H, Lasserre E Caissel I. Ileal low – pressure bladder replacement: Camey type II. Stapling technique and preliminary result (57 cases, 1987–1989). Eur Urol. 1990; 18(3): 161–5.

Hadzi-Djokic J. Urinery derivations. Beograd: Elit – Medica; 2009. (Serbian)

Hashimoto J, Takashi M, Kinjo T, Sahashi M, Murase T, Shimoji T, et al. Recurrence of transitional cell carcinoma in the left pelvis and ureter, and ileal conduit after total cystectomy: a case report. Hinyokika Kiyo 1987; 33(9): 1450−4. (Japanese)

Karadeniz T, Baran C, Topsakal M. Giant desmoid tumor in a case of ileal neobladder. Can J Urol 2010; 17(1): 5038−9.