Colorectal Adenocarcinoma Occurring in an Indiana Pouch

Abstract

The patient was an 84-year-old man who had undergone total cystectomy and Indiana pouch construction for bladder cancer in 1989. At the previous hospital in 2017, he was diagnosed with urinary tract infection due to a fever. Abdominal computed tomography showed elevated lesion in the pouch, and the patient was subsequently referred to our hospital. Under cystoscopy, biopsy from the tumor was adenocarcinoma. A scope inserted through the stoma revealed a 15mm 0-Is polyp in the pouch, and endoscopic mucosal resection (EMR) was performed. Histopathological findings were submucosal invasive cancer (tub2, pT1b, ly0, v0, budding grade1, pHMX, pVMX). Considering the patient's age, complications, and performance status, course observation was selected without additional resection despite being at high-risk on histopathological examination after EMR. A second cystoscopy using colonoscope performed 5 months after EMR showed no recurrence.