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Case Reports
. 2021 Jan 28;14(1):e238818.
doi: 10.1136/bcr-2020-238818.

Mixed histology bladder cancer as a complication of clam ileocystoplasty

Lawrence Nip  1 , Emil Salmo  2 , Raveendra Surange  3 , John Calleary  3
Affiliations
Case Reports

Mixed histology bladder cancer as a complication of clam ileocystoplasty

Lawrence Nip et al. BMJ Case Rep. .

Abstract

A 58-year-old woman with a previous clam ileocystoplasty was referred to the urology department for the investigation of haematuria. CT urogram showed a large left-sided soft tissue mass arising from the bladder. Histological analysis of the shavings from transurethral resection revealed a G3pT2 transitional cell carcinoma and T4N1Mx adenocarcinoma. The patient was referred to oncology for the discussion of palliative chemotherapy; however, in the interim she deteriorated and was admitted to hospital with a post-renal acute kidney injury. A right-sided nephrostomy was inserted relieving her obstruction and she subsequently made a good recovery. This case report illustrates the difficulties in the long-term follow-up of patients having undergone what is now a rarely performed procedure. In the absence of regular cystoscopic follow-up post ileocystoplasty, malignancy may present late and with complications from advanced disease.

Keywords: haematuria; urological cancer; urological surgery; urology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Schematic depicting the key operative steps in an ileocystoplasty procedure. Figure kindly provided by Miss Jaissie Ngan, independent illustrator.
Figure 2
Figure 2
(A) CT urogram coronal section showing the bladder mass invading the vaginal vault. (B) CT urogram coronal section showing a small left kidney with hydronephrosis.
Figure 3
Figure 3
(A) MRI pelvis coronal section showing the left lateral bladder wall tumour with extravesical spread and involvement of the vaginal vault. (B) MRI pelvis axial sections showing the left lateral bladder wall tumour with extravesical spread and involvement of the vaginal vault.
Figure 4
Figure 4
(A) Dimercaptosuccinic acid scan showing normal homogenous uptake of tracer in the right kidney only and no focal scarring. (B) Split function according to the geometric mean measures the right kidney at 99% and left kidney at 1%.
Figure 5
Figure 5
(A) Histology (H&E at 10× magnification) showed high-grade solid transitional cell carcinoma (lower image) invading the fibres of the muscularis propria (upper image). (B) There were separate fragments exhibiting invasive adenocarcinoma.
Figure 6
Figure 6
Trend of blood tests from admission to discharge. GFR, glomerular filtration rate.
See this image and copyright information in PMC

References

    1. CW L, Chang SJ, Hsieh CH. Systemic review of malignancy after ileocystoplasty [abstract]. Urol Sci 2016;27:S50 10.1016/j.urols.2016.05.186 - DOI
    1. Cheng PJ, Myers JB. Augmentation cystoplasty in the patient with neurogenic bladder. World J Urol 2020;38:3035–46. 10.1007/s00345-019-02919-z - DOI - PubMed
    1. Biardeau X, Chartier-Kastler E, Rouprêt M, et al. . Risk of malignancy after augmentation cystoplasty: a systematic review. Neurourol Urodyn 2016;35:675–82. 10.1002/nau.22775 - DOI - PubMed
    1. North AC, Lakshmanan Y. Malignancy associated with the use of intestinal segments in the urinary tract. Urol Oncol 2007;25:165–7. 10.1016/j.urolonc.2006.09.008 - DOI - PubMed
    1. Jackson MJ, Heer R, El-Sherif AM, et al. . Carcinoid tumour in an ileocystoplasty: a reminder to consider native bowel disease in the reconstructed urinary tract. Br J Med & Surg Urol 2011;4:39–41. 10.1016/j.bjmsu.2010.01.004 - DOI

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