De Novo Papillary Urothelial Carcinoma at a Previous Ureteroneocystostomy Site for Benign Ureteral Injury

ABSTRACT

Ureteroneocystostomy is a good treatment option for iatrogenic ureteral injury. Common complications at ureteroneocystostomy sites are strictures, stone formation, urinary infections, fistulas, and ureteral leaks. Here, we report a rare occurrence of urothelial carcinoma occurring at the site of a previous ureteral reimplantation. A 57-year-old female presented in the Emergency Department with left flank pain and chills. She had undergone a left ureteroneocystostomy with Boari flap due to iatrogenic ureteral obstruction during a laparoscopic left ovarian cystic mass excision 2 years ago. Computed tomography revealed left ureteral obstruction by the tumor at the neo-ureterovesical junction site. Both anterograde and retrograde ureteral catheterization approaches failed. We conducted a left percutaneous nephrostomy and administered antibiotics. Urine cytology was negative. We performed a left ureterovesical obstructive mass excision and Yang-Monti ileal ureter reconstruction. Biopsy of the ureteral-obstructing tumor revealed a low-grade papillary urothelial carcinoma. The patient’s symptoms and signs improved after surgery. To the best of our knowledge, this is the first report of a de novo urothelial carcinoma at the site of previous ureterovesical junction surgery. Urothelial carcinoma should be considered as one of the causes of stricture after ureteroneocystostomy. (Korean J Urol Oncol 2020;18:68-72)