Back to Search
Start Over
Secondary malignancy after urologic reconstruction procedures: a multi-institutional case series.
- Source :
-
Human pathology [Hum Pathol] 2022 Jan; Vol. 119, pp. 69-78. Date of Electronic Publication: 2021 Nov 19. - Publication Year :
- 2022
-
Abstract
- Urinary diversion and reconstructive urologic procedures are most often performed by incorporating various intestinal segments into the urinary tract. Although the risk of malignancy, among other complications, is well recognized and occurs most frequently after ureterosigmoidostomies and cystoplasties, data on the histopathologic and immunohistochemical characteristics of these tumors are scant. This study aims to evaluate the clinicopathological features of secondary tumors arising after urologic reconstruction procedures. Eleven cases were identified among five collaborating academic institutions. The average age was 51.7 years, and the M:F ratio was 8:3. Surgical procedures included 7 ileal conduits, 2 gastrocystoplasties, 1 augmentation cystoplasty not otherwise specified (NOS), and 1 Indiana pouch. Median time from reconstruction to malignancy was 36 years. Malignancy included adenocarcinoma in 10 patients (intestinal type in 6, gastric in 2, signet-ring cell in 1, undetermined type after neoadjuvant treatment in 1) and squamous cell carcinoma in 1. By immunohistochemistry, the adenocarcinomas were CK7 (45%), CK20 (89%), CK903 (78%), CDX2 (89%), SATB2 (67%), and beta-catenin (100%) positive. GATA-3 was negative in all cases. Pathologic stage was T1 (30%), T2 (40%), T3 (20%), and T4 (10%). Regional lymph node and distant metastasis were present in 60% and 20%, respectively. Treatment included multimodality therapy in most patients. On follow-up (mean, 27.4 months), 2 patients were dead (1 of disease), 3 were alive with disease, 4 were alive without disease, and 2 were lost to follow-up. Secondary malignancy arising within urologic reconstruction is rare, most frequently has adenocarcinoma morphology, presents late, and behaves aggressively.<br /> (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Subjects :
- Adenocarcinoma chemistry
Adenocarcinoma pathology
Adult
Aged
Biomarkers, Tumor analysis
Carcinoma, Squamous Cell chemistry
Carcinoma, Squamous Cell pathology
Female
Gastrointestinal Neoplasms chemistry
Gastrointestinal Neoplasms pathology
Humans
Male
Middle Aged
Neoplasm Staging
Retrospective Studies
Time Factors
Treatment Outcome
United States
Adenocarcinoma etiology
Carcinoma, Squamous Cell etiology
Gastrointestinal Neoplasms etiology
Plastic Surgery Procedures adverse effects
Urologic Surgical Procedures adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8392
- Volume :
- 119
- Database :
- MEDLINE
- Journal :
- Human pathology
- Publication Type :
- Academic Journal
- Accession number :
- 34801602
- Full Text :
- https://doi.org/10.1016/j.humpath.2021.11.004