scholarly journals Metastatic urothelial carcinoma of the bladder with sarcomatoid differentiation showing large cell neuroendocrine transformation in the liver; an unusual behaviour of a rare disease

2021 ◽  
pp. 101646
Author(s):  
Arya Bahadori ◽  
Munad Khan ◽  
Ehtesham Abdi ◽  
Colin Arnold
Keyword(s):  
Urothelial Carcinoma ◽  
Rare Disease ◽  
Large Cell ◽  
Unusual Behaviour ◽  
Metastatic Urothelial Carcinoma ◽  
Carcinoma Of The Bladder ◽  
Sarcomatoid Differentiation

scholarly journals Rectal metastasis from bladder urothelial carcinoma: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuki Ii ◽  
Shinya Munakata ◽  
Kumpei Honjo ◽  
Masaya Kawai ◽  
Shingo Kawano ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Tumor Resection ◽  
Disease Recurrence ◽  
Small Areas ◽  
Metastatic Urothelial Carcinoma ◽  
Rare Site ◽  
Difficult Defecation ◽  
Carcinoma Of The Bladder ◽  
Transitional Cells ◽  
Rectal Metastasis

Abstract Background Urothelial carcinoma arises from transitional cells in the urothelial tract. In advanced cases, it can metastasize locally to surrounding organs or distally to organs such as the lungs, bones, or liver. Here we describe a case of rectal metastasis from urothelial carcinoma treated with multiple sessions of transurethral resection of bladder tumor (TURBT). Case presentation A 72-year-old woman presented to our department with abdominal bloating andobstructed defecation. She had undergone two sessions of TURBT for early urothelial carcinoma in another hospital at 64 and 65 months ago, respectively. Cystoscopy at 3 months after the second TURBT session had indicated disease recurrence, and thus, she had been referred to our hospital for further examination, followed by TURBT for the third time at 59 months ago and for the fourth time at 48 months ago; thereafter, she had been followed up with cystoscopy every 6 months without any recurrence. However, she returned to our hospital, complaining of difficult defecation. Subsequent colonoscopy demonstrated an obstructive tumor in the rectum, which was pathologically diagnosed as metastatic urothelial carcinoma of the bladder. Laparoscopic examination revealed two small areas of peritoneal dissemination in the pelvis. A sigmoid colostomy was performed without rectal tumor resection. She has been receiving chemotherapy and is still alive 10 months after surgery. Conclusions Rectal metastasis is a rare site of metastasis for urothelial carcinomas. It is important to consider the possibility of annular rectal constriction caused by infiltrating or metastasizing urothelial carcinoma when managing patients with urothelial carcinoma and with difficult defecation.

Efficacy of High-Intensity Local Treatment for Metastatic Urothelial Carcinoma of the Bladder: A Propensity Score–Weighted Analysis From the National Cancer Data Base

2016 ◽  
Vol 34 (29) ◽  
pp. 3529-3536 ◽  
Author(s):  
Thomas Seisen ◽  
Maxine Sun ◽  
Jeffrey J. Leow ◽  
Mark A. Preston ◽  
Alexander P. Cole ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Urothelial Carcinoma ◽  
High Intensity ◽  
Cox Regression ◽  
Local Treatment ◽  
National Cancer Data Base ◽  
Cancer Data ◽  
Kaplan Meier ◽  
Metastatic Urothelial Carcinoma ◽  
Carcinoma Of The Bladder

Purpose Evidence from studies of other malignancies has indicated that aggressive local treatment (LT), even in the presence of metastatic disease, is beneficial. Against a backdrop of stagnant mortality rates for metastatic urothelial carcinoma of the bladder (mUCB) at presentation, we hypothesized that high-intensity LT of primary tumor burden, defined as the receipt of radical cystectomy or ≥ 50 Gy of radiation therapy delivered to the bladder, affects overall survival (OS). Patients and Methods We identified 3,753 patients within the National Cancer Data Base who received multiagent systemic chemotherapy combined with high-intensity versus conservative LT for primary mUCB. Patients who received no LT, transurethral resection of the bladder tumor alone, or < 50 Gy of radiation therapy delivered to the bladder were included in the conservative LT group. Inverse probability of treatment weighting (IPTW) –adjusted Kaplan-Meier curves and Cox regression analyses were used to compare OS of patients who received high-intensity versus conservative LT. Results Overall, 297 (7.91%) and 3,456 (92.09%) patients with mUCB received high-intensity and conservative LT, respectively. IPTW-adjusted Kaplan-Meier curves showed that median OS was significantly longer in the high-intensity LT group than in the conservative LT group (14.92 [interquartile range, 9.82 to 30.72] v 9.95 [interquartile range, 5.29 to 17.08] months, respectively; P < .001). Furthermore, in IPTW-adjusted Cox regression analysis, high-intensity LT was associated with a significant OS benefit (hazard ratio, 0.56; 95% CI, 0.48 to 0.65; P < .001). Conclusion We report an OS benefit for individuals with mUCB treated with high-intensity versus conservative LT. Although the findings are subject to the usual biases related to the observational study design, these preliminary data warrant further consideration in randomized controlled trials, particularly given the poor prognosis associated with mUCB.

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