Long-term survival after radical cystectomy and mesenteric lymph node dissection for squamous cell carcinoma arising fro
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CASE REPORT
Long‑term survival after radical cystectomy and mesenteric lymph node dissection for squamous cell carcinoma arising from augmented bladder with lymph node metastasis: a case report Takahiko Soma1 · Minato Yokoyama1 · Yusuke Uchida1 · Susumu Kirimura2 · Hajime Tanaka1 · Soichiro Yoshida1 · Yoh Matsuoka1 · Yasuhisa Fujii1 Received: 8 June 2020 / Accepted: 10 August 2020 © The Japan Society of Clinical Oncology 2020
Abstract Surgical resection is commonly performed for augmented bladder cancer, yet an optimal treatment strategy for augmented bladder cancer with lymph node metastasis has not been established. Here, we report a case that achieved 7 years of survival after radical cystectomy and mesenteric lymph node dissection for squamous cell carcinoma arising from augmented bladder with lymph node metastasis. Extended surgery could be a useful treatment option for locally advanced augmented bladder cancer including mesenteric lymph node metastasis. Keywords Surgery · Squamous cell carcinoma · Augmentation cystoplasty
Introduction It is known that cancer often develops long after augmentation cystoplasty [1, 2]. While the dominant histological types are adenocarcinoma and urothelial carcinoma, squamous cell carcinoma (SCC) is also seen in some cases [3]. For augmented bladder cancer, surgical resection is commonly performed, yet an optimal treatment strategy for augmented bladder cancer with lymph node metastasis has not yet been established. For augmented bladder cancer arising from the ileal segment, treatment strategies for small intestine cancer can be applied. According to the current guidelines on small intestine cancer [4, 5], a recommended treatment for resectable disease is up-front radical surgical resection including the mesenteric lymph nodes and adjacent organs if needed. The need for adjuvant chemotherapy is still controversial. Here, we report a case of SCC arising from the ileal segment of an augmented bladder with mesenteric lymph * Takahiko Soma [email protected] 1
Department of Urology, Tokyo Medical and Dental University, 1‑5‑45, Yushima, Bunkyo‑ku, Tokyo 113‑8519, Japan
Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan
2
node metastasis, diagnosed 47 years after augmentation cystoplasty.
Case report A 73-year-old man who had undergone left nephrectomy and augmentation cystoplasty for left renal and bladder tuberculosis at the ages of 27 and 29, respectively, presented with gross hematuria in 2008. Urine cytology, cystoscopy, computed tomography, and magnetic resonance imaging revealed no malignant findings at that time. For the next 4 years, he received regular follow-up examinations. In May 2012, urine cytology turned positive, suggesting SCC. Although the native bladder tissue that could be observed by cystoscopy was intact, an augmented bladder tumor with a mesenteric lymph node swelling of 1.5 cm was identified by computed tomography (Fig. 1 a, b). In magnetic resonance images, the tumor demonstrated low signal intensity
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