A 68-year-old man presented with macroscopic hematuria. The diagnostic ultrasound revealed a bladder tumor. The Computed Tomography (CT)-scan showed no prevalent metastatic lesions, while an ectopic left pelvic kidney was discovered (). The biopsy showed a high grade muscle invasive urothelial carcinoma. Radical cystoprostatectomy with extended lymphadenectomy was performed with conversion to an ileal pouch (). Twenty-one lymph nodes were resected. The final pathology showed a pT2aG3 urothelial carcinoma and multiple sites of urothelial in situ carcinoma. There are no signs of metastatic disease 1.5 years after cystectomy.
A 73-year-old man presented with macroscopic hematuria. A pT1 g3 urothelial carcinoma was diagnosed at initial histology, while a re-TUR Bladder confirmed it. Preoperatively, an ectopic pelvic left kidney was reported. A BCG regimen was started and after 2 years a muscle-invasive bladder carcinoma was diagnosed. Staging CT showed no metastatic lesions. Radical cystoprostatectomy with standard lymphadenectomy, removing all nodal tissue cranially up to the common iliac bifurcation, was performed. Seventeen lymph nodes were excised. The ureters were anastomosed to an ileal conduit (). Final pathologic report revealed a pT2 g3 urothelial carcinoma with no involvement of any lymph nodes, while all surgical margins were clear. After 2.5 years of followup the patient remains free of disease.