Document Detail

Metastatic adenocarcinoma after augmentation gastrocystoplasty.
MedLine Citation:
PMID:  18206936     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Augmentation gastrocystoplasty has been proposed as an alternative to enterocystoplasty because of potential benefits, including decreased risk of mucus production, stone formation and urinary tract infections. Although cancer has rarely been reported in this patient population, it is a well recognized potential risk of all augmentation cystoplasties. To define better the risk of malignancy associated with gastric augmentation and the appropriate surveillance protocol for these patients, we describe our experience in 2 patients with metastatic adenocarcinoma following gastrocystoplasty. MATERIALS AND METHODS: We retrospectively reviewed the charts of all patients who had undergone augmentation gastrocystoplasty between 1990 and 1994. Of the 72 patients identified 2 were diagnosed with a primary malignancy arising from the augmented bladder. Charts were reviewed for medical history, clinical outcomes and pathology. RESULTS: Two patients were identified with a primary bladder malignancy after gastrocystoplasty. Both patients had metastatic disease at initial presentation. Neither patient had a history of gross hematuria, recurrent urinary tract infections or pain before initial presentation. Mean patient age at augmentation was 5.5 years. Mean age at diagnosis of malignancy was 19.5 years, with a mean time from augmentation of 14 years. CONCLUSIONS: Although the risk of bladder cancer is low after gastric augmentation, the effects may be life threatening. Therefore, we advocate routine annual surveillance with cystoscopy, bladder biopsy and upper tract imaging in all patients who have undergone augmentation gastrocystoplasty.
Vijaya M Vemulakonda; Thomas S Lendvay; Margarett Shnorhavorian; Byron D Joyner; Henry Kaplan; Michael E Mitchell; Richard W Grady
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-01-18
Journal Detail:
Title:  The Journal of urology     Volume:  179     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-03     Completed Date:  2008-03-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1094-6; discussion 1097     Citation Subset:  AIM; IM    
Department of Urology, University of Washington School of Medicine and Division of Pediatric Urology, Children's Hospital and Regional Medical Center, Seattle, Washington 98105, USA.
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MeSH Terms
Adenocarcinoma / diagnosis,  etiology*,  therapy
Anastomosis, Surgical
Child, Preschool
Retrospective Studies
Stomach / surgery
Stomach Neoplasms / diagnosis,  etiology*,  therapy
Urethral Diseases / surgery
Urinary Bladder / surgery
Urinary Bladder Neoplasms / diagnosis,  etiology*,  therapy
Urologic Diseases / surgery
Urologic Surgical Procedures / adverse effects*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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