Clinical case:

A 48-year-old man had a direct family history (mother) of colon cancer. His current illness began with mucosuria, dysuria, pollakiuria, and stranguria. He was given different antibiotics, but response was unsatisfactory. Cystoscopy revealed a primary lesion of approximately 1.5 cm located in the bladder dome that was confirmed through contrast-enhanced tomography of the chest, abdomen, and pelvis. The tumor measured 1.9 x 1.8 x 2.0 cm, with no extension to the lymph nodes or distant organs. Treatment consisted of partial cystectomy of the pedunculated, mucinous tumor in the bladder dome, as well as bilateral pelvic lymphadenectomy, leaving 2-cm margins that were macroscopically tumor-free. A transurethral Foley catheter was placed, with no complications. The catheter was removed at postoperative week 3, with no signs of urinary alterations. The histopathologic study reported: a 2.5-cm villous adenoma with a focus of colonic adenocarcinoma infiltrating the muscularis mucosae, with tumor-free surgical margins.

Conclusion:

Villous adenoma is a premalignant lesion of the digestive tract that can affect the descending colon. Urologic manifestation is rare and almost always appears in urointestinal anastomoses or the urachus. If the histopathologic specimen has foci of adenocarcinoma or moderate-to-severe dysplasia the disease can predispose to bladder cancer.

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