膀胱拡大術後37年目に発生した膀胱腺癌の1例

A 57-year-old man had undergone right nephrectomy at 10 years of age and bladder augmentation using the ileum at 20 years for treatment of urinary tract tuberculosis. He also had undergone intermittent catheterization after a traffic accident at 49 years of age. He presented at another hospital with a complaint of asymptomatic macroscopic hematuria. Cystoscopy revealed a lobulated tumor in the bladder. Transurethral resection of bladder tumor was performed, but complete resection was difficult. Histopathological examination of the specimen revealed a well differentiated adenocarcinoma. He was referred to our hospital for total cystectomy and percutaneous left nephrostomy. The tumor arose from the bladder wall near the anastomotic site between the bladder and the ileal segment. Histopathological examination revealed a well differentiated adenocarcinoma infiltrating into the muscle layer (pT2a). Postoperatively, he has been free of recurrence for one year. This is the 19th case of adenocarcinoma following bladder augmentation using the ileum reported in the Japanese literature.