ANASTOMOTIC SITE CARCINOMA IN A PATIENT ON URETEROSIGMOIDOSTOMY AFTER 2 DECADES. IMPORTANCE OF SCREENING RE-EMPHASIZED.

Abstract

Colonic carcinoma arising from the site
of a functioning ureterosigmoidostomy
anastomosis is a recognized late complication
.This article reports one such case
and re-emphasizes on the value of
screening following ureterosigmoidostomy.
A 27 year old male a known
case of Exstrophy Epispadias complex
for which he has undergone Ureterosigmoidostomy
and excision of the bladder
at the age of 1 year completely lost followup.
He presented with right loin pain
and fever for the past 1 month. CT scan
of the KUB region showed a right hydroureteronephrosis
and a growth in the
site of Ureterosigmoidostomy. Sigmoidoscopy
showed a proliferative growth in
the ureterosigmoidostomy site which on
biopsy was reported as adenocarcinoma.
The patient underwent right
nephroureterectomy and sigmoidectomy.
The left ureter was brought out through
an ileal conduit.Patients with
ureterointestinal anastomosis need periodic
screening to rule out malignancy at
the anastomotic site. The incidence is 100-
550 times that of the general population
.Hence all patients should have a flexible
sigmoidoscopy once per year, commencing
atleast 10 years after surgery.