Mixed histology bladder cancer as a complication of clam ileocystoplasty

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

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.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / pathology*
  • Anastomosis, Surgical
  • Carcinoma, Transitional Cell / diagnostic imaging
  • Carcinoma, Transitional Cell / pathology*
  • Female
  • Humans
  • Ileum / transplantation*
  • Middle Aged
  • Neoplasms, Multiple Primary / diagnostic imaging
  • Neoplasms, Multiple Primary / pathology*
  • Transplants / diagnostic imaging
  • Transplants / pathology*
  • Urinary Bladder / surgery*
  • Urinary Bladder Neoplasms / diagnostic imaging
  • Urinary Bladder Neoplasms / pathology*
  • Urinary Incontinence, Urge / surgery