Verrucous Carcinoma of a Suprapubic Cystostomy Track

0022-5347/96/1561-0174$03.00/0 Vol. 156, 174,July 1996 Printed in U.S.A.

THE JOURNAL OF UROLOGY

Copyright 0 1996 by

A M E R I C A N UROLOCICAL ASSOCIATION, I N C .

VERRUCOUS CARCINOMA OF A S U P W U B I C CYSTOSTOMY TRACK PHILMORE A. BLAKE, CHARLES 0. KIM, ARMAND0 E. LOPEZ AND ARNON KRONGRAD From the Departments of Urology and Medicine, University of Miami School of Medicine and Miami Veterans Administration Medical Center, Miami, Florida

KEYWORDS:bladder, carcinoma, cystostomy

gina, perianal region, penis, lower extremities and oral cavity. The few reported cases of verrucous carcinoma of the bladder have been mostly associated with Bilharzia.1 CASE REPORT Although no evidence of metastases has been reported, A 37-year-old man with a C5 spinal cord injury and a verrucous carcinoma is considered malignant because of 17-year history of a suprapubic cystostomy tube presented its growth pattern. It has been mostly treated with exciwith a 2 X 4 cm. exophytic soft tissue mass surrounding the sion. Extravesical extension has been successfully treated suprapubic tube. Multiple incisional biopsies were nondiag- with surgical removal.2 To our knowledge our report represents the first case of nostic. The patient was observed for 32 months. The mass enlarged, and cystoscopy showed diffuse ery- verrucous carcinoma arising in a suprapubic cystostomy thema. Random bladder biopsies and repeat biopsies of the track. The fact that the patient is well so long after surgical suprapubic mass showed verrucous carcinoma of the supra- treatment suggests that verrucous carcinoma of the suprapubic skin. Metastatic evaluation, including chest x-ray and pubic track does not differ biologically from verrucous carciabdominal computerized tomography, was negative. Radical nomas at other sites, and that it can be effectively treated cystectomy and excision of the suprapubic track were per- with surgical excision. formed. Pathological examination of the surgical specimen revealed well differentiated verrucous carcinoma arising in the suprapubic skin without extension into the bladder or REFERENCES subcutaneous tissues. At 20 months of followup the patient is 1. Homer, S. A., Fisher, H. A. G., Barada, J. H., Eastman, A. Y., well without any clinical or radiological recurrence.

To our knowledge we report the first case of verrucous carcinoma arising in a suprapubic cystostomy track.

DISCUSSION

Verrucous carcinoma is a well differentiated variant of squamous cell carcinoma, which occurs in the cervix, vaAccepted for publication January 26, 1996.

Migliozzi, J. and Ross, J. S.: Verrucous carcinoma of the bladder. J. Urol., 145 1261,1991. 2. Ellsworth, P.I., Schned, A. R., Heaney, J. A. and Snyder, P. M.: Surgical treatment of verrucous carcinoma of the bladder unassociated with bilharzial cystitis: case report and literature review. J. Urol., 153: 411, 1995.

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