High Grade Urothelial Carcinoma in Neobladder Replacement: An Unusual Form of Recurrence 9 Years After Radical Cystoprostatectomy

Introduction: The recurrence of urothelial carcinoma on a neobladder made from ileal is an infrequent entity. Radical cystectomy is the standard treatment for muscle-invasive bladder cancer.Case presentation: We report here the case of a 68-year-old patient with a history of radical cystoprostatectomy with Hautman-technique of enterocystoplasty replacement 9 years ago, followed by adjuvant chemotherapy for urothelial carcinoma pT2G3N1M0 + CIS. The patient was followed up regularly and did not return for his control visit. He was admitted to the emergency room with acute urinary retention on clotting hematuria. A cystoscopic examination with a tumor biopsy was performed, and the anatomic-pathological result favored a recurrence of a high-grade urothelial carcinoma infiltrating the intestinal mucosa. The extension workup by abdominopelvic CT showed a secondary location in the liver with a suspicious left latero-aortic lymph node mass. In agreement with a multidisciplinary consultation meeting, the patient was referred to oncology for chemotherapy.Conclusion: Tumor recurrence should be evoked in patients with hematuria after replacement enterocystoplasty Although urothelial carcinoma in orthotopic neobladder is unusual. However, in these rare situations, it is essential to quickly manage the patient in a reference center with multidisciplinary consultations to optimize adequate care.