Abstract
Bladder cancer represents a considerable issue in Egypt and the Middle East. Radical cystectomy and orthotopic neobladder represent the standard of care for managing cases with invasive bladder tumour. There are few cases reported in the literature considering the urothelial recurrence in the urethra, connected to neobladder. We are presenting a rare case of a young female patient, with an aggressive urothelial tumour, recurring 13-year post-radical cystectomy, and the Studer neobladder. Our case was managed by urethrectomy and conversion of the neobladder into continent reservoir, with good short-term oncological and functional outcomes. We can conclude that bladder cancer cases should be followed thoroughly throughout their life. Follow-up urethroscopy and cytology should be done for all cases of post-radical cystectomy, regardless of patients’ symptoms.Key messageLate urothelial recurrence of post-radical cystectomy is possible and, in our case, happened 13 years following surgery. The Studer neobladder can be safely converted into continent reservoir, allowing good functional outcomes. Also, recurrence in the Studer neobladder can be safely managed, allowing good oncological outcomes, without the need for any ureteroileal interventions.
Highlights
Carcinoma of the urinary bladder, being the second most common genitourinary malignancy, is considered as a major health problem in Egypt and the Middle East [1, 2].Radical cystectomy is the gold standard treatment for patients with muscle invasive bladder cancer, with 5 years overall survival rate of 50–70% [3]
The case had a history of muscle invasive bladder urothelial tumour that was managed 13 years ago by anterior pelvic exenteration and the Studer neobladder
Stein et al [4] reported a low-urethral recurrence rate in 2% of 841 women managed by radical cystectomy and orthotopic neobladder, over a follow-up, exceeding 20 years
Summary
Carcinoma of the urinary bladder, being the second most common genitourinary malignancy, is considered as a major health problem in Egypt and the Middle East [1, 2]. Our case is unique because it presents an aggressive urothelial tumour, with squamoid differentiation, initially diagnosed while the patient was 45 years old. The tumour did not show any recurrence during 10 years post-surgical management. Advanced urothelial recurrence was found 13-year post-radical cystectomy, and the pathological study showed the same initial specimen pathological findings. The case had a history of muscle invasive bladder urothelial tumour that was managed 13 years ago by anterior pelvic exenteration and the Studer neobladder. No endoscopic or cytology follow-up studies were done This follow-up was stopped after 10 years, the patient presented to our outpatient clinic 3 years later complaining of recurrent attacks of haematuria. The last follow-up of the patient is 3 months following surgery, showing adequate healing and catheterizable umbilical stoma, with no urine leak. Close follow-up will be going on for the possibility of recurrence
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
