title: Vesicoenteric, vesicovaginal, vesicocutaneous fistula -an unusual complication with intravesical mitomycin.
abstract: Intravesical instillation of mitomycin C is a routine practice for treatment of superficial transitional cell carcinoma of bladder. Despite usual precautions serious side effects like fistulation can occur with diverse presentation as illustrated by this report. The pathology demonstrates a dense necrotic and massive inflammatory reaction in the peri vesical tissue following the extravasation of an intravesically administered chemotherapeutic agent. The severe inflammatory tissue response and the necrotic effect associated with the extravasated chemotherapeutic agent could potentially lead to local sepsis with a subsequent fistula formation.
authors.affiliation: James Cancer Hospital, Ohio State University and Comprehensive Cancer Center, Columbus, Ohio, USA.
authors.forename: Pankaj P
authors.initials: PP
authors.lastname: Dangle
authors.forename: Wenle Paul
authors.initials: WP
authors.lastname: Wang
authors.forename: Kamal S
authors.initials: KS
authors.lastname: Pohar
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D017577:Cutaneous Fistula / Q000139:chemically induced*; D005218:Fat Necrosis / Q000139:chemically induced; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000139:chemically induced* / Q000000981:diagnostic imaging; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D001747:Urinary Bladder Fistula / Q000139:chemically induced* / Q000000981:diagnostic imaging; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy; D014719:Vesicovaginal Fistula / Q000139:chemically induced* / Q000000981:diagnostic imaging
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin