Mucinous adenocarcinoma of bladder. Case associated with extensive intestinal metaplasia of urothelium in patient with nonfunctioning bladder for twelve years.

A mucin-secreting adenocarcinoma of the bladder arose in a fifty-one-year-old man twelve years after he had an ileal conduit and urinary diversion for a neurogenic bladder which was due to a myelomeningocele. The patient presented with a mucinous penile discharge, and cystoscopy showed several papillary tumors with mucoid material coating the intervening mucosa. Examination of the resected bladder showed almost total intestinal metaplasia of the urothelium with numerous foci of dysplasia, adenocarcinoma in situ, papillary and invasive adenocarcinoma. The clinical and pathologic features of this case and the risk of carcinoma developing in a nonfunctioning bladder are discussed.