Bell Michael A, Wright Edward J, Fang Sandy H, Johnson Michael H, Sopko Nikolai A
The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Marburg 420, Baltimore, MD 21287, USA.
Department of Surgery, Ravitch Division of GI Surgery, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Sheikh Zayed Tower, Baltimore, MD 21287, USA.
Urol Case Rep. 2018 Jan 11;17:53-55. doi: 10.1016/j.eucr.2018.01.008. eCollection 2018 Mar.
Adenocarcinoma is a rare finding following urinary diversion with gastrointestinal segments. This report describes an 80-year-old woman with a history of bladder cancer who subsequently developed a pT4 adenocarcinoma 8 years following her radical cystectomy and Indiana Pouch continent urinary diversion. An en bloc resection of the pouch and affected small bowel was performed and the patient underwent conversion to an ileal conduit diversion. We use this case to highlight a mechanism for possible pathogenesis and the management of adenocarcinoma in urinary diversions including the need for regular surveillance and the surgical approach.
腺癌是胃肠道段尿路改道术后罕见的发现。本报告描述了一名80岁有膀胱癌病史的女性，在根治性膀胱切除术和印第安纳袋可控性尿路改道术后8年发生了pT4腺癌。对尿袋和受累小肠进行了整块切除，患者接受了回肠导管改道。我们用这个病例来强调尿流改道腺癌可能的发病机制和治疗方法，包括定期监测的必要性和手术方式。
