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December 3, 1982

Bladder Carcinoma After Urinary Diversion

JAMA. 1982;248(21):2885-2886. doi:10.1001/jama.1982.03330210067039

CARCINOMA of the defunctionalized bladder is considered a rare entity. Eleven cases have been reported.1-8 Diagnosis is often delayed and sometimes is an unexpected finding at cystectomy. We report a case that illustrates this problem and review the literature.

Report of a Case  A 52-year-old woman underwent urinary diversion in 1960 because of incontinence related to spina bifida and paraplegia. Aside from a left ureterolithotomy in 1974, she had no problems referable to her urinary tract and no signs or symptoms of vesical irritation or pyocystis. In February 1981, she reported a five-month history of "bleeding from the vagina." Gynecologic evaluation, including Papanicolaou's smear and dilatation and curettage, gave normal findings. Five months later, because of persistent bleeding, her bladder was catheterized and 50 mL of blood was aspirated. Once it was recognized that the bleeding was from the bladder, urologic evaluation ensued. Cystoscopy demonstrated an inflammatory mucosal lesion