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Peteinaris A, Perros P, Prokopakis I, Fasoulakis Z, Ntounis T, Daglas K, Kostopoulou IE, Samara AA, Pagonis K, Tatanis V, Faria-Costa G, Xhaferi R, Arzumanyan K, Martínez BB, Chionis A, Pergialiotis V, Daskalakis G, Kontomanolis EN, Koutras A. Bladder Cancer during Pregnancy: A Review of the Literature. J Pers Med 2023; 13:1418. [PMID: 37763185 PMCID: PMC10533129 DOI: 10.3390/jpm13091418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
Bladder malignancy represents the fourth most common cancer in men and the eighth in women in the western world. Women under 75 years of age have a risk of 0.5-1% of developing bladder cancer. The diagnosis usually occurs between 65 and 70 years of age, whereas the mortality rate for women varies from 0.5 to 4 per 100,000 every year. Nulliparous women present a greater risk than women who have given birth. The risk is further decreased when parity increases. Theoretically, hormonal changes occurring during pregnancy play a protective role. Smoking and occupational exposure to specific chemicals are the most common risk factors of bladder cancer. Other risk factors such as chronic urinary tract inflammation, cyclophosphamide, radiotherapy, and familial correlation have been reported. The aim of this review is to highlight a rare combination, which is the co-existence of bladder malignancy and pregnancy. We present thirteen different cases of women who were diagnosed with malignant bladder tumors during their pregnancy. A review of the literature was conducted, focusing on the unspecific symptoms, possible diagnostic tools, and suitable treatment modalities. The management of bladder cancer in pregnancy is a challenging process. The fragile balance between the possible complications of pregnancy and maternal health is yet to be discussed.
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Affiliation(s)
- Angelis Peteinaris
- Department of Urology, University of Patras Medical School, 26504 Patras, Greece; (A.P.); (K.P.); (V.T.)
| | - Paraskevas Perros
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, General Hospital of Athens ‘ALEXANDRA’, Lourou and Vasilissis Sofias Ave., 11528 Athens, Greece; (P.P.); (I.P.); (Z.F.); (T.N.); (V.P.); (G.D.); (A.K.)
| | - Ioannis Prokopakis
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, General Hospital of Athens ‘ALEXANDRA’, Lourou and Vasilissis Sofias Ave., 11528 Athens, Greece; (P.P.); (I.P.); (Z.F.); (T.N.); (V.P.); (G.D.); (A.K.)
| | - Zacharias Fasoulakis
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, General Hospital of Athens ‘ALEXANDRA’, Lourou and Vasilissis Sofias Ave., 11528 Athens, Greece; (P.P.); (I.P.); (Z.F.); (T.N.); (V.P.); (G.D.); (A.K.)
| | - Thomas Ntounis
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, General Hospital of Athens ‘ALEXANDRA’, Lourou and Vasilissis Sofias Ave., 11528 Athens, Greece; (P.P.); (I.P.); (Z.F.); (T.N.); (V.P.); (G.D.); (A.K.)
| | - Konstantinos Daglas
- Department of Obstetrics and Gynecology, Laiko General Hospital of Athens, Agiou Thoma 17, 11527 Athens, Greece; (K.D.); (A.C.)
| | | | - Athina A. Samara
- Department of Embryology, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece
| | - Konstantinos Pagonis
- Department of Urology, University of Patras Medical School, 26504 Patras, Greece; (A.P.); (K.P.); (V.T.)
| | - Vasileios Tatanis
- Department of Urology, University of Patras Medical School, 26504 Patras, Greece; (A.P.); (K.P.); (V.T.)
| | - Gabriel Faria-Costa
- 1st Department of Urology, Local Health Unit of Matosinhos, 4464-513 Matosinhos, Portugal;
| | - Rudi Xhaferi
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Urology, Careggi Hospital, University of Florence, 50134 Florence, Italy;
| | - Karen Arzumanyan
- Department of Urology, Yerevan State Medical University Named after M. Heratsi, Yerevan 0025, Armenia;
| | | | - Athanasios Chionis
- Department of Obstetrics and Gynecology, Laiko General Hospital of Athens, Agiou Thoma 17, 11527 Athens, Greece; (K.D.); (A.C.)
| | - Vasilios Pergialiotis
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, General Hospital of Athens ‘ALEXANDRA’, Lourou and Vasilissis Sofias Ave., 11528 Athens, Greece; (P.P.); (I.P.); (Z.F.); (T.N.); (V.P.); (G.D.); (A.K.)
| | - George Daskalakis
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, General Hospital of Athens ‘ALEXANDRA’, Lourou and Vasilissis Sofias Ave., 11528 Athens, Greece; (P.P.); (I.P.); (Z.F.); (T.N.); (V.P.); (G.D.); (A.K.)
| | - Emmanuel N. Kontomanolis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Vasilissis Sofias Str. 12, 67100 Alexandroupolis, Greece;
| | - Antonios Koutras
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, General Hospital of Athens ‘ALEXANDRA’, Lourou and Vasilissis Sofias Ave., 11528 Athens, Greece; (P.P.); (I.P.); (Z.F.); (T.N.); (V.P.); (G.D.); (A.K.)
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Singh G, Chawla S, Nandy P, Rajput M. A Large Bladder Tumor During Pregnancy: Twin Challenge. JOURNAL OF UROLOGICAL SURGERY 2022. [DOI: 10.4274/jus.galenos.2022.2021.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Rojas PA, González C, Mendez GP, Majerson A, San Francisco IF. Bladder squamous cell carcinoma in a pregnant woman: case report and review of the literature. BMC Urol 2021; 21:4. [PMID: 33407316 PMCID: PMC7788849 DOI: 10.1186/s12894-020-00772-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/10/2020] [Indexed: 12/02/2022] Open
Abstract
Background Bladder tumors in pregnancy are extremely rare. No more than 50 cases have been published to date, including all histologic variants, and only three cases of bladder squamous cell carcinoma have been described. Case presentation We present a clinical case of a 31-year-old woman with bladder squamous cell carcinoma in the second trimester of pregnancy. After a C-section at 30 weeks, we performed radical cystectomy with extended bilateral lymphadenectomy, hysterectomy and right oophorectomy. The Studer neobladder technique was performed for urinary tract reconstruction. Definitive pathology showed invasive bladder squamous cell carcinoma, Grade 2, with microscopic infiltration of the perivesical fat, negative margins, and 3/28 lymph nodes with carcinoma (pT3aN2M0). The patient underwent 18 months of surveillance after radical cystectomy, without recurrence by PET-CT. Conclusions Bladder cancer in pregnant women is extremely rare but must be considered in those with recurrent gross hematuria and/or recurrent urinary tract infection. To our knowledge, this case involves the longest recurrence-free survival of a pregnant woman with squamous cell bladder cancer published thus far.
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Affiliation(s)
- Pablo A Rojas
- Departamento de Urología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Cristián González
- División de Ginecología y Obstetricia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gonzalo P Mendez
- Departamento de Anatomía-Patológica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandro Majerson
- Departamento de Urología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Ignacio F San Francisco
- Departamento de Urología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile.
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Maggen C, Linssen J, Gziri MM, Zola P, Cardonick E, de Groot CJM, Garcia AC, Fruscio R, Drochytek V, Van Calsteren K, Albersen M, Amant F. Renal and Bladder Cancer During Pregnancy: A Review of 47 Cases and Literature-based Recommendations for Management. Urology 2020; 151:118-128. [PMID: 33203520 DOI: 10.1016/j.urology.2020.08.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/23/2020] [Accepted: 08/10/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To provide contemporary gestational age-specific recommendations for management, a retrospective series of patients with renal or bladder cancer during pregnancy is reported. METHODS Obstetric and oncological data of pregnant patients with a diagnosis of renal or bladder cancer were selected from the worldwide registry of the International Network of Cancer, Infertility and Pregnancy. In addition, the literature was reviewed for recent case reports since last reviews in 2014 for renal cancer and 2004 for bladder cancer. RESULTS International Network of Cancer, Infertility and Pregnancy registered 22 cases (14 renal cancer and 8 bladder cancer), diagnosed between 1999 and 2017, and the literature reported 15 cases with renal cancer and 10 cases with bladder cancer between 2004 and 2019. Most common symptoms for renal and bladder cancer were pain (28%) and hematuria (66%), respectively. In more than half of the patients, surgical treatment was performed during pregnancy. Preterm deliveries were mostly medically induced (12 of 17, 71%) and all patients with a planned delivery before 34 weeks had advanced cancer. For renal and bladder cancer respectively, 79% and 87% of patients obtained complete remission. Advanced cancer stages had worse prognosis; 3 of 7 patients with known follow-up deceased within 15 months after diagnosis. CONCLUSION Gestational age at diagnosis determines further management of renal and bladder cancers during pregnancy. Advanced stages challenge decision-making. The maternal needs for immediate treatment, and the neonatal risks including the impact of a preterm delivery should be discussed in a multidisciplinary setting while respecting the patient's autonomy.
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Affiliation(s)
- Charlotte Maggen
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
| | - Jasmijn Linssen
- Department of Gynecological Oncology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Mina Mhallem Gziri
- Department of Obstetrics, Cliniques Universitaires St Luc, UCL, Sint-Lambrechts-Woluwe, Belgium
| | - Paolo Zola
- Department Surgical Sciences, University of Torino, Torino, Italy
| | - Elyce Cardonick
- Department of Obstetrics and Gynecology, Cooper, University Health Care, Camden, New Jersey, USA
| | - Christianne J M de Groot
- Department of Obstetrics and Gynecology, and Amsterdam Reproduction and Development, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Alvaro Cabrera Garcia
- Hospital Regional de Alta Especialidad de Ixtapaluca (HRAEI) " Reference clinic for hemato-oncological diseases during pregnancy CREHER" Estado de México, México
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, University of Milan - Bicocca, San Gerardo Hospital, Monza, Italy
| | - Vit Drochytek
- Faculty Hospital Kralovske, Vinohrady and 3rd Medical Faculty, Charles University, Prague, Czech Republic
| | - Kristel Van Calsteren
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Frédéric Amant
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium; Department of Gynecological Oncology, Amsterdam University Medical Centres, Amsterdam, The Netherlands; Department of Gynecological Oncology, Amsterdam University Medical Centres, Amsterdam, The Netherlands and the Department of Gynecology, Antoni van Leeuwenhoek - Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Ren X, Xia H, Gao Z. Inflammatory myofibroblastic tumor of the urinary bladder during pregnancy: A case report. Oncol Lett 2015; 9:2233-2235. [PMID: 26137047 DOI: 10.3892/ol.2015.2992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 01/29/2015] [Indexed: 12/30/2022] Open
Abstract
A 31 year-old pregnant female who had not menstruated for 31 weeks presented to The Affiliated Hospital of Chifeng College (Chifeng, China) with painless gross hematuria, which had been present for 10 days. A computed tomography scan revealed a tumor of 5.8×6.3 cm in diameter. A biopsy was not obtained prior to surgery. Following the initial workup, the patient underwent a cesarean section and partial cystectomy of bladder. Pathological examination revealed inflammatory myofibroblastic tumor (IMT). An initial cytoscope examination was performed one year after surgery, with subsequent follow-up cystoscope examinations performed every three months, and at the time of writing the patient was alive, with no evidence of tumor recurrence. IMT of the urinary bladder is a rare benign lesion and to the best of our knowledge, this is the first reported case describing IMT of the urinary bladder during pregnancy. This study describes the process of diagnosis and management of the patient.
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Affiliation(s)
- Xiaolei Ren
- Department of Urology, The Affiliated Hospital of Chifeng College, Chifeng, Inner Mongolia Autonomous Region 024000, P.R. China
| | - Haibo Xia
- Department of Urology, The Affiliated Hospital of Chifeng College, Chifeng, Inner Mongolia Autonomous Region 024000, P.R. China
| | - Zhiming Gao
- Department of Urology, The Affiliated Hospital of Chifeng College, Chifeng, Inner Mongolia Autonomous Region 024000, P.R. China
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Lakmichi MA, Zehraoui R, Dahami Z, Moudouni SM, Bassir A, Soumani A, Sarf I. Bladder cancer in the second trimester of pregnancy: tough decisions. A case report with review of the literature. Ther Adv Urol 2012; 4:139-42. [PMID: 22654966 DOI: 10.1177/1756287212441961] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report a rare case of a patient presenting with a nonmuscle invasive papillomatosis transitional cell carcinoma of the bladder in the second trimester of pregnancy. We describe the management dilemmas encountered and the challenging treatment option selected to optimize outcome for the patient and infant. Close collaboration between urologists, obstetricians and medical colleagues is needed for optimal, safe and effective management of bladder tumours during pregnancy.
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Affiliation(s)
- Mohamed Amine Lakmichi
- Assistant Professor, Urology Surgeon, Urology Department, University Hospital Center Mohammed the VIth, Faculty of Medicine and Pharmacy, Cadi Ayyad University, No. 2, Avenue Menara, Bab Jdid, Marrakesh, Morocco
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Fiadjoe P, Kannan K, Rane A. Maternal urological problems in pregnancy. Eur J Obstet Gynecol Reprod Biol 2010; 152:13-7. [PMID: 20483528 DOI: 10.1016/j.ejogrb.2010.04.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Revised: 04/05/2010] [Accepted: 04/26/2010] [Indexed: 11/29/2022]
Abstract
Urological conditions in pregnancy represent a major diagnostic and therapeutic challenge. During pregnancy the urinary tract undergoes some anatomical and physiological changes that may result in many symptoms and pathological conditions affecting both the mother and fetus. With prompt evaluation and expeditious treatment, the prognosis is good. Fear of causing harm is unfounded. This article describes urological problems in pregnancy, specifically infection, calculus, renal failure, renal tumour, lower urinary tract symptoms and trauma and their management.
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Affiliation(s)
- Paul Fiadjoe
- Department of Urogynaecology, The Townsville Hospital, Angus Smith Drive Douglas, Townsville, QLD 4814, Australia.
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Pentheroudakis G, Pavlidis N. Gastrointestinal, urologic and lung malignancies during pregnancy. Recent Results Cancer Res 2008; 178:137-164. [PMID: 18080450 DOI: 10.1007/978-3-540-71274-9_13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- G Pentheroudakis
- Department of Medical Oncology, Ioannina University Hospital, Greece
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