PMC9829220_01
Magnetic resonance imaging illustrating a tumor on the right wall of the bladder (arrowheads). (A) Axial plane. (B) Coronal plane. (C) Sagittal plane.
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Magnetic resonance imaging revealed a MIBC on the right wall of the bladder, which was confirmed by cystoscopy (Fig. 1).
Contrast-enhanced computed tomography image illustrating: (A) Right kidney (arrowheads); (B) left ectopic kidney (arrowheads); (C) right pelvis and ureter (arrows), left pelvis and ureter (arrowheads).
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The ectopic kidney did not fuse with the contralateral kidney and the ureter of the ectopic kidney maintains its normal insertion into the bladder (Fig. 2).
Intraoperative images. (A) Right ureter (arrows), left ectopic ureter (arrowheads) and left ectopic kidney (dotted circles). (B) Right ureter. (C) Left ectopic ureter. (D) Ureters sutured together (Wallace technique). (E) Ureteral plate and conduit segment. (F) Fixation of the conduit to the peritoneum.
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The right ureter was dissected and secured as usual (Fig. 3A and B). Although the left displaced ureter was difficult to dissect due to dense adhesions to the surrounding tissues, the dissection and securing of the ureter based on a thorough pre-operative review, was successfully achieved (Fig. 3C). The left ureter was of sufficient length, and a standard ileal stoma was created with a uretero-ileal anastomosis using the Wallace method in the ICUD (Fig. 3D-F).
Macroscopic findings of the resected specimen. A tumor was found on the right wall of the bladder (arrowheads).
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Upon further follow-up, the histopathological diagnosis of the resected specimen revealed that this was an invasive urothelial carcinoma, high-grade, pT2aN0Mx tumor with negative surgical margins (Fig. 4).
Contrast-enhanced computed tomography image at 2 months post-surgery illustrating: (A) Right kidney (arrowheads); (B) left ectopic kidney (arrowheads).
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A CT scan was obtained at 2 months post-surgery, which revealed no obvious cancer recurrence or metastasis, and no evidence of hydronephrosis (Fig. 5).