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

Abstract

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.

Case of the Month from the University Hospital of Bern, Switzerland: Urothelial carcinoma in an orthotopic neobladder: reported cases and pathophysiological hypotheses

“…Recurrences in the intestine used for urinary derivation are extremely rare and, to our knowledge, only a few cases are described in the literature (Table 1) In most of the reported cases the recurrences within the bladder substitute occur in the area of anastomoses with the remaining urinary tract, in the uretero-ileal [6][7][8]14,17,20,21] or urethro-ileal anastomoses [9,19]. These recurrences are of course less atypical compared to true recurrences in the ileal OBS.…”

Urothelial Carcinoma Recurrence in an Orthotopic Neobladder without Urethral or Upper Urinary Tract Involvement

“…The development of recurrent solitary or multifocal tumors in the urinary tract is a well-known characteristic of urothelial cell carcinoma. After urinary diversion, recurrences have been reported to occur in the urethra [1–3], upper urinary tract [4], and ileal conduit [6], at the ureteroenteric anastomosis [5–7], as well as colonic mucosa of an ileocolonic neobladder [12]. Direct invasion and implantation are the two proposed hypotheses for urothelial carcinoma recurrence in any part of the urinary tract, including segments of bowel used for urinary diversion.…”

“…The orthotopic ileal neobladder has become the preferred method of continent urinary diversion following radical cystectomy for bladder cancer. Urothelial carcinoma recurrence has been widely reported involving the urethra [1–3], upper urinary tract [4], or the ureteroenteric anastomosis [5–7]. However, isolated recurrences within the neobladder without concomitant disease in the remnant urothelium are exceedingly rare, with only 3 other case reports in the literature (Table 1).…”

Urothelial Carcinoma Recurrence in an Ileal Neobladder Nine Years after Primary Surgery with Muir-Torre Syndrome

“…Some cases of secondary adenocarcinoma developing in a replaced bowel segment of urinary diversions have been reported. Secondary adenocarcinoma developed 20 years after surgery in about 0.5% of those in whom an ileal segment was used [ 8 ]. In our knowledge, only 6 cases, including ours, are published in the literature [ 2 – 6 ] ( Table 1 ).…”