Adenocarcinoma In A Colon Conduit

Abstract

Development of adenocarcinoma in a colon conduit is extremely rare. We report a case of adenocarcinoma manifesting 22 years after formation of a colon conduit. CASE REPORT A 31-year-old white man presented with gross hematuria from the urostomy. The patient had a history of neurogenic bladder (probably due to posterior urethral valves), multicystic dysplastic kidneys and bilateral vesicoureteral reflux found at age 2 months, for which he underwent bilateral cutaneous ureterostomy. At age 17 months he subsequently underwent right nephrectomy for renal nonfunction. Despite revisions of the left ureterostomy, he ultimately required left nephrectomy at age 10 years. That same year he underwent colon conduit urinary diversion in anticipation of a living related renal transplant, which was performed 2 months later. He did well for 22 years until gross hematuria developed. Conduit x-ray, computerized tomography (fig. 1) and endoscopy revealed a 3.5 cm. mid conduit papillary lesion, that was 5 cm. distal to the ureteral anastomosis. Endoscopic resection demonstrated moderately differentiated adenocarcinoma invading the muscularis (fig. 2). The colon conduit was resected and replaced with an ileal conduit. Pathological examination revealed no residual tumor. DISCUSSION