Villous tumor in the bladder reconstructed with ileal ureter replacement

Abstract

Background: Development of late urointestinal neoplasms after bowel incorporation into the urinary tract is an ongoing hazard.
Case: A 61-year-old woman, who had right nephrectomy 46 years earlier and ileal replacement of the left ureter due to tuberculosis 26 years earlier reported macroscopic hematuria and a mass prolapsed through the urethra. Urine cytology showed clusters of tall columnar cells. Nuclei were slightly enlarged, oval to elongated, and slightly irregular with a few prominent nucleoli. Mitotic figures were not found. Cystoscopy showed a villous tumor with much mucin in the bladder, necessitating ileocystectomy. Most of the tumor was in the bladder, with some in the ileum. The tumor showed villous proliferation of atypical mucin-producing cells. Atypicality was mild to moderate, and no stromal invasion was found.
Conclusion: Long-term follow-up and precise examination of urinary cytology are maudatory for patients with bladders reconstructed using the ileum.