Abstract
BackgroundWe present a case of asynchronously occurring adenocarcinomas 29 and 36 years after ureterosigmoidostomy for bladder cancer, respectively, at both anastomosis sites.Case presentationA colonoscopy that was performed on a 69-year-old man because of bloody stool and an elevated carcinoembryonic antigen (CEA) level revealed a polypoid lesion at the right ureterosigmoid anastomosis site 29 years after the patient’s ureterosigmoidostomy. Endoscopic resection was performed, and the lesion was diagnosed as adenocarcinoma. Seven years later (36 years after ureterosigmoidostomy), an elevated lesion was detected at the left ureterosigmoid anastomosis site by colonoscopy performed after detection of high CEA levels. Biopsy revealed an adenocarcinoma that was immunohistologically positive for CDX2; sigmoidectomy and ureterectomy were subsequently performed. The pathological diagnosis of the second tumor was adenocarcinoma arising in the ureterosigmoid anastomosis site and invading the left ureter.ConclusionsDiligent long-term follow-up of patients who underwent ureterosigmoidostomy is essential.
Highlights
We present a case of asynchronously occurring adenocarcinomas 29 and 36 years after ureterosigmoidostomy for bladder cancer, respectively, at both anastomosis sites.Case presentation: A colonoscopy that was performed on a 69-year-old man because of bloody stool and an elevated carcinoembryonic antigen (CEA) level revealed a polypoid lesion at the right ureterosigmoid anastomosis site 29 years after the patient’s ureterosigmoidostomy
We discuss a rare case of adenocarcinoma occurring at both ureterosigmoid anastomosis sites; one was detected 29 years after the procedure while the other was detected 36 years afterwards
Blood tests indicated renal dysfunction, acidosis, and hyperchloremia; this was thought to be caused by the prior ureterosigmoidostomy and re-absorption of urine into
Summary
Ureterosigmoidostomy used to be commonly performed to treat bladder cancer. the procedure was recently abandoned because of complications such as hyperchloremia, renal failure, urinary infection, and adenocarcinoma at the ureterosigmoid anastomosis site. Case presentation A man underwent total cystectomy and ureterosigmoidostomy at 40 years of age to treat his bladder cancer. When he was 69 years old, he presented to our hospital with bloody stools and elevated tumor marker levels. During a follow-up visit 7 years later, the patient’s CEA level was found to be elevated (25.3 ng/mL), and CT revealed a mass lesion at the left anastomosis site of the ureterosigmoidostomy. On admission, his breathing was deep and continuous (Kussmaul rhythm). Blood tests indicated renal dysfunction, acidosis, and hyperchloremia (creatinine: 1.72 mg/dL; pH: 7.252; chloride: 112 mEq/L); this was thought to be caused by the prior ureterosigmoidostomy and re-absorption of urine into
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