Bladder adenocarcinoma following gastrocystoplasty.
Bladder augmentation with segments of small bowel (ileocystoplasty), large intestine (colocystoplasty) or stomach (gastrocystoplasty) has been used to treat patients with small or noncompliant bladders by increasing the capacity or compliance. Carcinomas following gastrocystoplasty have been observed in the segments of stomach; however, to our knowledge, carcinoma arising in the residual native bladder has not been reported. We report the first case of adenocarcinoma arising in the residual native bladder in association with intestinal metaplasia and dysplasia of bladder mucosa 17 years following gastrocystoplasty. Intestinal metaplasia secondary to recurrent urinary infection, chronic inflammation, and some form of irritation may potentiate the development of native bladder adenocarcinoma. Patients with gastrocystoplasty are at an increased risk for carcinoma in stomach segments and require close long-term follow up; however, the risk of carcinoma in native bladder is still unclear.