Cutaneous paraneoplastic presentation of colon cancer in a patient with history of ureterosigmoidostomy

Abstract

Ureterosigmoidostomy was commonly utilized as a procedure for continent urinary diversion. However, ureterosigmoidostomy is associated with complications such as infection, electrolyte disturbances, and neoplasia development. A 40-year-old Caucasian male presented with acute left flank pain. Past medical history was significant for bladder exstrophy for which ureterosigmoidostomy urinary diversion was performed during childhood. On physical exam, multiple circular erythematous patches were scattered across the forearms that had been presented for 2 years. Cross-sectional imaging demonnttated an ill-defined mass at the site of ureteral implantation with associated severe left hydroureteronephrosis. Endoscopy revealed a mass at the site of ureteral implantation and biopsy demonstrated invasive, poorly differentiated adenocarcinoma. The dermatosis was diagnosed as interstitial granulomatous dermatitis, a rare inflammatory skin condition associated with underlying autoimmune disease or malignancy. Patient elected operative management with left nephrectomy, sigmoidectomy, and ileal conduit diversion. Ihis case demonnttates a rare presentation of cutaneous paraneoplastic syndrome after development of colon cancer after ureterosigmoidostomy. Ureterooolonic urinary diversion has a demonnttaaie risk of neoplasia development at the anastomotic site, requiring routine endoscopic surveillance.

Keywords

Bladder exstrophy / Paraneoplastic syndrome / Ureterosigmoiddstomy

Acknowledgments

None.

Statement of ethics

University Hospitals does not require ethical approval for reporting individual cases or case series. Written informed consent from the patient to publish anonymized case information and photographs has been obtained.

Conflict of interest statement

The authors declare that they have no financial conflict of interest with regard to the content of this report.

Funding source

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author contributions

MS: Initial manuscript draft;AF: Revised manuscript draft;TS: Dermatologic review and insight;MP: Photography and imaging documentation;KM, LB, DB: Additional case review and manuscript revision.

All authors reviewed and edited the manuscript and approved the final version of the manuscript.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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