A case of adenocarcinoma occurring in ileal segment 31 years after ileocystoplasty

We report a case of adenocarcinoma occurring in the implanted ileum 31 years after ileocystoplasty. A 63-yearold male patient was hospitalized with lower abdominal pain. He had undergone ileocystoplasty for a tuberculous contracted bladder at the age of 32. Ultrasonic examinations, cystography and pyelography revealed marked thickening of the wall of the implanted ileal tube and severe stenosis, which was distant from the enterovesical anastomosis. Biopsy of the lesion led to a histological diagnosis of well differentiated adenocarcinoma. Cytologically, urinary specimens were composed of neoplastic cells, degenerative epithelial columnar cells with dysplastic features of various degrees and transitional cells. The neoplastic cells were characterized by a high nuclear: cytoplasmic raito, a rounded and eccentric nucleus with a prominent eosinophilic nucleolus and intracytoplasmic droplets positive for PAS staining; they formed clusters showing an irregular arrangement of cells. Post-ileocystoplasty patients must be followed up long-term, using repeat cytologic examination of the urine.