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We read with interest the case report of an adenocarcinoma arising in a gastrocystoplasty . The authors also mention another report of a transitional cell carcinoma developing within a gastrocystoplasty  . We would like to point out however that a signet ring cell variant of adenocarcinoma within a gastrocystoplasty has also been described . Briefly a 36-year-old man presented with renal failure...
We read with interest the case report of an adenocarcinoma arising in a gastrocystoplasty . The authors also mention another report of a transitional cell carcinoma developing within a gastrocystoplasty  . We would like to point out however that a signet ring cell variant of adenocarcinoma within a gastrocystoplasty has also been described . Briefly a 36-year-old man presented with renal failure having undergone a gastrocystoplasty for the treatment of a neuropathic bladder fourteen years earlier. He was subsequently found to have an anaplastic signet ring cell carcinoma which was invading the muscularis propria of both the gastric and vesical segments at the anastomosis and extended into the intramural segment of the wall of the left ureter. These observations would suggest that tumour formation is a late, but significant complication of gastrocystoplasty. Sixty cases of carcinoma formation within augmentation cystoplasties have now been described and there is evidence to suggest that the enterocystoplasties are genetically unstable and have an inherent potential for tumour formation [4-6]. Furthermore,
tumours arising within enterocystoplasties are often aggressive, have a high mortality and are not usually detected by routine follow up cystoscopy .
There is some evidence to indicate that histological changes characteristic of chronic inflammation, metaplasia, and dysplasia as well as benign and malignant neoplasms may be more common in gastrocystoplasties than in either colocystoplasties or ileocystoplasties [8,9]. We agree with the authors that patients with a gastrocystoplasty should be followed up long term but would suggest that such patients
should be informed of the potential risks of long term malignant transformation before undergoing the procedure. We would also suggest that it may be worthwhile to determine whether chromosomal abnormalities at the gastrovesical anastomosis may be useful in identifying those patients most at risk from malignant transformation.
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