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Carcinoma of the colon arising at ureteral implant sites despite early external diversion: Pathogenetic and clinical implications

Colon carcinomas develop at the site of implantation in approximately 6% of patients who undergo ureterosigmoidostomy for benign conditions. Generally, the obstruction of a long‐functioning uretero‐sigmoidostomy heralds the presentation of the malignancy. The development of a carcinoma of the colon at the site of the ureteral stump 22 years after conversion to ileal conduit in a ureterosigmoidostomy, which had been in place for only nine months, raises fundamental questions about the pathogenesis of the tumor. The long‐assumed role of urine in the induction of these iatrogenic tumors must be questioned. This issue and suggestions for management and prevention are discussed.