AB014. SOH25_AB_174. Adenocarcinoma of ileal conduit 40 years after radical cystectomy

Background: Bladder cancer is the eighth most common malignancy in Ireland. Most common is transitional cell carcinoma. Less common subtypes include squamous cell carcinoma, adenocarcinoma and sarcoma. Radical cystectomy with urinary diversion is standard surgical treatment for localised muscle invasive bladder cancers. Urinary diversion is most commonly achieved by an ileal conduit (IC). We present an 89-year-old female that attended our service with an adenocarcinoma of her IC 40 years post-cystectomy.

Methods: A retrospective chart review was completed. A literature review on tumours affecting ICs was also conducted.

Results: An 89-year-old woman presented with a painless, progressively enlarging mass on the abdominal surface of her IC, 40 years after radical cystectomy. The previous year she had undergone refashioning of her stoma due to stenosis and since then had been nephrostomy dependent. Previously she had never experienced other stoma complications. Biopsy revealed adenocarcinoma of the IC. Computed tomography (CT) showed filling defects in the left ureter, considered likely additional tumour foci. Our patient was managed conservatively given her existing nephrostomies, and according to her and her family’s wishes.

Conclusions: IC is associated with long-term complications including stenosis, chronic kidney disease and metabolic derangements. However, malignancy of the IC is very rare, with the literature limited mainly to case reports and series. In our centre there have been no similar recorded cases. Additionally, complications with first presentation at such a late stage after conduit formation is unusual; most literature is limited to much shorter-term follow up. Our case demonstrates the need for long-term cohort studies on patients with ICs and their outcomes.

Keywords: Adenocarcinoma; bladder cancer; ileal conduit (IC); surgery; urology