Secondary Colonic Adenocarcinoma After Continent Cutaneous Urinary Diversion a.m. Lundiana-An Aggressive Disease Entity With High Risk of Locally Advanced Disease and Metastases

INTRODUCTION: We herein report two patients developing secondary adenocarcinomas arising in colonic segments used for urinary diversion a.m. Lundiana in a population-based series 16 and 27 years after cystectomy, respectively. CASE PRESENTATION: Following initial partial resection of the pouch, both patients experienced local recurrence; one subsequently developed distant metastases and died from secondary adenocarcinoma, whereas the other patient underwent extirpation of the pouch and re-diversion with an ileal conduit. CONCLUSIONS: Based on these patients, upfront radical surgery would have been a more effective treatment. In this patient population, clinical awareness but not screening for secondary adenocarcinomas seems to be the most appropriate strategy.