Hadzi-Djokić Jovan, Pejcić Tomislav, Andrejević Vladan, Djurasić Ljubomir
Serbian Academy of Sciences and Arts, Belgrade, Serbia.
Urological Clinic, Clinical Center of Serbia, Belgrade, Serbia.
Vojnosanit Pregl. 2013 Nov;70(11):1062-4. doi: 10.2298/vsp1311062h.
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.
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.
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.
目前已有一些关于尿流改道术置换肠段发生继发性腺癌的病例报道。在使用回肠段的患者中,约0.5%在术后20年发生继发性腺癌。文献中有几篇报道描述了移行细胞癌(TCC)从远端输尿管延伸至回肠导管。50%的肠袢肿瘤组织学类型为TCC。大多数病例中肿瘤的部位是尿道口或造口处。
我们报告了1例罕见病例,患者在根治性膀胱前列腺切除术及采用Camey II术式行回肠新膀胱置换术后12年,原位回肠新膀胱发生移行细胞癌。一名65岁患有新膀胱高级别尿路上皮癌的男性接受了新膀胱部分切除术及右肾输尿管切除术。病理分析显示回肠新膀胱存在高级别尿路上皮癌(G II,T2b期)。患者术后1年死于喉癌。
原位新膀胱肿瘤若能及时诊断则可行手术治疗。在本病例中,手术仅导致新膀胱容量减少,而对控尿本身无影响。