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Follicular Lymphoma Arising in an Ileal Neobladder Presenting as a Large Pelvic Mass
Ken Fujita1, Takato Nishino1, Masaki Shimbo1
1Department of Urology St. Luke's International Hospital Chūō Japan.
Introduction:
Secondary malignancies arising in intestinal segments used for urinary diversion are rare, and reports of malignant lymphoma are extremely limited. We report a rare case of follicular lymphoma arising in an ileal neobladder 20 years after radical cystectomy.
Case Presentation:
An 81-year-old man had undergone radical cystectomy with ileal neobladder reconstruction for muscle-invasive bladder cancer (pT2bN0M0) 20 years earlier and had remained recurrence-free. Follow-up imaging incidentally revealed a large pelvic mass contiguous with the neobladder and multiple enlarged lymph nodes. Transurethral resection led to a diagnosis of follicular lymphoma. Treatment with bendamustine plus rituximab achieved marked tumor reduction without severe adverse events.
Conclusion:
Malignant lymphoma arising in urinary diversion organs is extremely rare. This case highlights the potential for late-onset lymphoid malignancies following urinary diversion and emphasizes the need for long-term clinical awareness of secondary malignancies in such patients.
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