Carcinoma at the site of ureterosigmoidostomy

A 31-year-old woman who had undergone bilateral ureterosigmoidostomy at age five had a moderately differentiated adenocarcinoma at the anastomotic site that was not detected by preoperative studies or intraoperative palpation. The authors review other reports of anastomotic carcinomas occurring after ureterosigmoidostomy for benign disease and recommend a diagnostic protocol. Whenever the urine is diverted away from the sigmoidostomy (rediversion), the anastomotic site should be resected. Ureterosigmoidostomy should be undertaken only with the understanding that meticulous long-term follow-up is mandatory.