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Mohammed MH, Mardnly F, Ghrer M, Alia L, Assad LW. Unusual metastasis after radical cystectomy: case report. J Surg Case Rep 2024; 2024:rjae112. [PMID: 38455984 PMCID: PMC10918444 DOI: 10.1093/jscr/rjae112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/11/2024] [Indexed: 03/09/2024] Open
Abstract
Cutaneous metastasis of urothelial carcinoma after radical cystectomy is extremely rare. We present the case of a 57-year-old man who underwent a radical cystectomy with ileal conduit for the presence of a bladder tumor. He developed a cheek lesion after 2 months, which was diagnosed as a metastatic nodule along with bone metastases from high-grade bladder urothelial carcinoma. This nodule was treated with surgical removal with subsequent chemotherapy, but he succumbed after 10 months due to widespread metastatic disease.
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Affiliation(s)
- Mohammed H Mohammed
- Urology, Damascus University, Al Assad University Hospital, Damascus 30621, Syria
| | - Fadel Mardnly
- Urology, Damascus University, Al Assad University Hospital, Damascus 30621, Syria
| | - Mohamad Ghrer
- Urology, Damascus University, Al Assad University Hospital, Damascus 30621, Syria
| | - Louei Alia
- Urology, Damascus University, Al Assad University Hospital, Damascus 30621, Syria
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2
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Elumalai RK, Gupta N, Verma R, Belho ES. 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in the Evaluation of Unusual Cutaneous Manifestation of Carcinoma Urinary Bladder. Indian J Nucl Med 2020; 35:251-252. [PMID: 33082687 PMCID: PMC7537928 DOI: 10.4103/ijnm.ijnm_48_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 03/23/2020] [Accepted: 07/01/2020] [Indexed: 11/05/2022] Open
Abstract
Bladder cancer is one of the most common malignancies of the urinary tract. Cutaneous metastasis of bladder carcinoma is extremely rare with a limited number of cases, resulting mainly from iatrogenic seeding. Here, we present scan findings of cutaneous metastasis in a known case of carcinoma urinary bladder. The 18F FDG PET/CT scan revealed FDG avid nodular thickening of the skin and sub-cutaneous tissue with ulcerations involving anterior pelvic wall, walls of the scrotum and the base of the penis. Histopathology confirmed the diagnosis of cutaneous and subcutaneous metastasis.
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Affiliation(s)
- Ram Kumar Elumalai
- Department of Nuclear Medicine and PET/CT, Mahajan Imaging Centre, Sir Ganga Ram Hospital, New Delhi, India
| | - Nitin Gupta
- Department of Nuclear Medicine and PET/CT, Mahajan Imaging Centre, Sir Ganga Ram Hospital, New Delhi, India
| | - Ritu Verma
- Department of Nuclear Medicine and PET/CT, Mahajan Imaging Centre, Sir Ganga Ram Hospital, New Delhi, India
| | - Ethel Shangne Belho
- Department of Nuclear Medicine and PET/CT, Mahajan Imaging Centre, Sir Ganga Ram Hospital, New Delhi, India
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3
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Kerkeni W, Ayari Y, Charfi L, Bouzouita A, Ayed H, Cherif M, Ben Slama M, Mrad K, Derouiche A, Chebil M. Transitional Bladder Cell Carcinoma Spreading to the Skin. Urol Case Rep 2017; 11:17-18. [PMID: 28083478 PMCID: PMC5220250 DOI: 10.1016/j.eucr.2016.11.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 11/27/2016] [Accepted: 11/30/2016] [Indexed: 11/18/2022] Open
Abstract
Cutaneous metastases from bladder malignancies are rare. We report the case of a 74 year old man who underwent cysto-prostatectomy and adjuvant chemotherapy for a pT3b N+ bladder transitional cell carcinoma. Four months later, he presented with skin disseminated pigmented lesions. Skin biopsy confirmed cutaneous metastasis from urothelial carcinoma.
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Affiliation(s)
- W. Kerkeni
- Urology Department, Charles Nicolle University Hospital, Tunis, Tunisia
- Corresponding author. Urology Department, Charles Nicolle University Hospital of Tunis, Boulevard du 9 avril 1938, Tunis 1006, Tunisia.Urology DepartmentCharles Nicolle University Hospital of TunisBoulevard du 9 avril 1938Tunis1006Tunisia
| | - Y. Ayari
- Urology Department, Charles Nicolle University Hospital, Tunis, Tunisia
| | - L. Charfi
- Department of Anatomopathology, Salah Azaiez Institute, Tunis, Tunisia
| | - A. Bouzouita
- Urology Department, Charles Nicolle University Hospital, Tunis, Tunisia
| | - H. Ayed
- Urology Department, Charles Nicolle University Hospital, Tunis, Tunisia
| | - M. Cherif
- Urology Department, Charles Nicolle University Hospital, Tunis, Tunisia
| | - M.R. Ben Slama
- Urology Department, Charles Nicolle University Hospital, Tunis, Tunisia
| | - K. Mrad
- Department of Anatomopathology, Salah Azaiez Institute, Tunis, Tunisia
| | - A. Derouiche
- Urology Department, Charles Nicolle University Hospital, Tunis, Tunisia
| | - M. Chebil
- Urology Department, Charles Nicolle University Hospital, Tunis, Tunisia
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Lees AN. Cutaneous metastasis of transitional cell carcinoma of the urinary bladder eight years after the primary: a case report. J Med Case Rep 2015; 9:102. [PMID: 25943325 PMCID: PMC4427993 DOI: 10.1186/s13256-015-0585-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 04/02/2015] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION Cutaneous metastasis of bladder carcinoma is extremely rare with a limited number of published cases. An awareness of this rare clinical entity and high index of suspicion is needed for diagnosis, as it can occur months or rarely as in this case, even years, after the primary cancer. CASE PRESENTATION An 81-year-old Caucasian man presented with a one-year history of increasing left leg swelling and a two-month history of a macular-nodular rash on the anterior thigh, on a background of a high-grade (WHO Grade 2 of 3) papillary and invasive transitional cell carcinoma of the bladder in 2006. Following investigations, he was diagnosed as having probable locoregional recurrence of previously resected urothelial cancer of the bladder with extensive retrograde lymphatic permeation into the left thigh with cutaneous eruptions of malignancy. He completed a planned course of palliative radiation therapy to the left thigh lesions (30 Gy divided over 10 fractions) as well as the left pelvic node (a total dose of 18 Gy divided over six fractions). The disease ran an aggressive course and our patient died six months after the diagnosis of cutaneous metastases. CONCLUSIONS Metastatic disease should always be considered in the differential diagnosis in patients with a previous history of bladder cancer who present with cutaneous nodules, even many years after the initial diagnosis at the primary site.
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Affiliation(s)
- Andrea Nicole Lees
- Royal Hobart Hospital, 48 Liverpool Street, Hobart, Tasmania, 7000, Australia.
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Açıkgöz O, Ölçücüoğlu E, Kasap Y, Yığman M, Güneş ZE, Gazel E. Metastatic transitional cell carcinoma presenting with skin metastasis. Int J Crit Illn Inj Sci 2015; 5:53-5. [PMID: 25810966 PMCID: PMC4366830 DOI: 10.4103/2229-5151.152346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Transitional cell carcinomas (TCC) of upper urinary system account for 5% of all TCCs. The incidence of such metastases ranges from 0.18% to 2%. Experimental studies reported a general unsatisfactory survival time following skin metastasis. We report in this paper a case of metastatic urinary system TCC, which had become evident with a skin lesion in the right hypogastric region. A 60-year-old female patient with a history of being operated upon due to renal pelvic TCC was admitted to our outpatient clinic with complaints of red skin lesion in the near vicinity of the operational incision scar for 3 months. Her medical history revealed nothing but nephroureterectomy operation on the upper urinary system; moreover, it was learned that she had been ignoring what was recommended to her for routine controls. Thoraco-abdominal computed tomographic (CT) examination performed on the basis of aforementioned findings depicted a mass lesion of 24*20 mm dimension with high contrast uptake detected within the subcutaneous fat tissue in the right abdominal wall. The skin lesion depicted in CT was surgically excised. The pathological examination of the excised material was reported to be compatible with TCC. The patient was referred due to abdominal lesion to medical oncology after the operation. Followed up under chemotherapy protocol, the patient died 3 months after the metastasectomy operation. Skin metastasis of upper urinary system TCCs, especially renal pelvic TCCs, are quite rare conditions. Among the likely skin sites of metastasis for genitourinary system TCCs are head, face, extremities, suprapubic region and abdomen. Taking into consideration the low survival rates, the importance of early diagnosis of recurrences and/or distant metastases should be better appreciated. These patients die soon after the skin metastasis even with the administration of aggressive therapy. Similarly, our patient died 90 days after the diagnosis of skin metastasis despite the oncologic therapy.
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Affiliation(s)
- Onur Açıkgöz
- Department of Urology, Turkey Yüksek ?htisas Training and Research Hospital, Ankara, Turkey
| | - Erkan Ölçücüoğlu
- Department of Urology, Turkey Yüksek ?htisas Training and Research Hospital, Ankara, Turkey
| | - Yusuf Kasap
- Department of Urology, Turkey Yüksek ?htisas Training and Research Hospital, Ankara, Turkey
| | - Metin Yığman
- Department of Urology, Turkey Yüksek ?htisas Training and Research Hospital, Ankara, Turkey
| | - Zeki Ender Güneş
- Department of Urology, Turkey Yüksek ?htisas Training and Research Hospital, Ankara, Turkey
| | - Eymen Gazel
- Department of Urology, Turkey Yüksek ?htisas Training and Research Hospital, Ankara, Turkey
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6
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Tumor seeding of percutaneous nephrostomy tract from urothelial carcinoma of the kidney. Case Rep Urol 2013; 2013:819470. [PMID: 24288648 PMCID: PMC3833001 DOI: 10.1155/2013/819470] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 09/27/2013] [Indexed: 11/18/2022] Open
Abstract
Urothelial carcinoma (UC) of the renal pelvis has been rarely shown to metastasize to the skin. Tumor seeding from iatrogenic procedures is a source of spreading of UC to the skin. We herein present a case of primary UC of the renal pelvis with spreading to the skin from a percutaneous nephrostomy tract.
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Metastatic pattern of bladder cancer: correlation with the characteristics of the primary tumor. AJR Am J Roentgenol 2011; 196:117-22. [PMID: 21178055 DOI: 10.2214/ajr.10.5036] [Citation(s) in RCA: 148] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the metastatic pattern of muscle-invasive bladder cancer and to correlate the findings with the characteristics of the primary tumor. MATERIALS AND METHODS From a clinic population of 392 patients with muscle-invasive (pT2-4) bladder cancer seen at our institution from January 2004 through December 2009, we studied the cases of 150 consecutively registered patients with pathologically proven metastatic disease. The metastasis-free intervals and metastatic patterns of different T categories were compared by Kruskal-Wallis test and Freeman-Halton extension of Fisher's exact test. Patients were divided into two histologic categories, those with transitional cell carcinoma and those with atypical histologic features. The metastasis-free interval and metastatic pattern of these two groups were compared by Mann-Whitney test and Fisher's exact test. RESULTS The study group consisted of 150 patients (116 men [77%], 34 women [23%]; median age, 64 years). The transitional cell carcinoma group consisted of 94 (63%) patients and the atypical histologic features group of 56 (37%) patients. The most common metastatic sites were lymph nodes (104 patients, 69%), bone (71 patients, 47%), lung (55 patients, 37%), liver (39 patients, 26%), and peritoneum (24 patients, 16%). Patients with tumors of a more advanced T category had shorter metastasis-free intervals (p = 0.001, df = 2). There was no significant difference in the metastatic patterns of tumors in the different T categories. Patients with atypical histologic features had a shorter median metastasis-free interval (3 months; range, 0-29 months) than patients with transitional cell carcinoma (12 months; range, 0-192 months) (p = 0.0001). Patients with atypical histologic features had a significantly higher incidence of peritoneal metastasis (p < 0.0002). CONCLUSION Lymph nodes, bones, lung, liver, and peritoneum are the most common sites of metastasis from bladder cancer. Tumors in a more advanced T category and those with atypical histologic features metastasize earlier. Tumors with atypical histologic features also have a higher frequency of peritoneal metastasis.
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Atmaca AF, Akbulut Z, Demirci A, Belenli O, Alici S, Balbay DM. Multiple subcutaneous nodular métastases from transitional cell carcinoma of the bladder. Pathol Oncol Res 2007; 13:70-2. [PMID: 17387392 DOI: 10.1007/bf02893444] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Accepted: 12/10/2006] [Indexed: 11/24/2022]
Abstract
Skin metastasis from transitional cell carcinoma (TCC) of the bladder is rare. In this report an uncommon metastasis of TCC of the bladder is presented.
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Affiliation(s)
- Ali Fuat Atmaca
- 1st Urology Clinic, Ankara Ataturk Training and Research Hospital, Ankara 06520, Turkey.
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10
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Mueller TJ, Wu H, Greenberg RE, Hudes G, Topham N, Lessin SR, Uzzo RG. Cutaneous metastases from genitourinary malignancies. Urology 2004; 63:1021-6. [PMID: 15183939 DOI: 10.1016/j.urology.2004.01.014] [Citation(s) in RCA: 134] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2003] [Accepted: 01/08/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To review the world literature for reports of cutaneous metastases from primary genitourinary malignancies and compare them with our experience during a 10-year period. Cutaneous metastases from primary visceral malignancies are uncommon manifestations of advanced disease. Among patients with urologic malignancies, the incidence and appearance of cutaneous metastases are not well established and recognition is poor among practicing urologists. METHODS A Medline search and manual bibliographic review was performed to identify peer-reviewed reports pertaining to cutaneous metastases from all visceral malignancies. A comparative review of all pertinent cases arising from primary urologic malignancies was performed. A comprehensive search of our institution's tumor registry was performed to identify all analytic cases of urologic malignancy diagnosed, treated, and followed up between 1990 and 2000. Clinical and pathologic data were collated. RESULTS We identified 2,369 reported cases of cutaneous metastases arising from 81,618 primary solid visceral malignancies, for an overall incidence of 2.9%. Dermatologic spread from primary urologic malignancies of the kidney, bladder, prostate, or testes was noted in 116 (1.3%) of 10,417. The incidence of cutaneous metastases from the kidney, bladder, prostate, and testes was 3.4%, 0.84%, 0.36%, and 0.4%, respectively. Overall, 436 cases of cutaneous metastases from urologic organs were identified in the English-language literature. We identified nine additional cases of pathologically confirmed cutaneous metastatic urologic tumors at our institution in the past 10 years. The most common presentation was an infiltrated plaque or nodules. Most cases displayed clinical features that mimicked common skin disorders. The median disease-specific survival was less than 6 months from the presentation of cutaneous metastasis. CONCLUSIONS Cutaneous metastases from urologic tumors are uncommon and occur in 1% of patients with advanced disease. Urologic skin metastases are most common from renal tumors, followed by those of the bladder and then prostate. Their clinical appearance may mimic other common dermatologic disorders affecting patients with advanced malignancies. Definitive diagnosis requires an index of suspicion and skin biopsy. Cutaneous metastases from urologic malignancies are associated with a poor prognosis.
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Affiliation(s)
- Thomas J Mueller
- Department of Urological Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA
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Pascual Regueiro D, García de Jalón Martínez A, Sancho Serrano C, Mallén Mateo E, Gil Sanz MJ, Azúa Romeo J, Rioja Sanz LA. [Skin metastasis of urothelial bladder tumor]. Actas Urol Esp 2003; 27:43-6. [PMID: 12701498 DOI: 10.1016/s0210-4806(03)72875-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We want to present a case of tranticional cell bladder carcinoma, where the first sign of disease progression was the appearance of a skin metastase. An unusual manifestation in a patient without another metastatic lesions.
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12
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Lin JT, Wang WH, Yen CC, Yu IT, Chen PM. Prurigo Nodularis as Initial Presentation of Metastatic Transitional Cell Carcinoma of the Bladder. J Urol 2002. [DOI: 10.1016/s0022-5347(05)64694-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jen-Tsun Lin
- From the Division of Medical Oncology, Department of Medicine and Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Hsu Wang
- From the Division of Medical Oncology, Department of Medicine and Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chueh-Chuan Yen
- From the Division of Medical Oncology, Department of Medicine and Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - I-Ting Yu
- From the Division of Medical Oncology, Department of Medicine and Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Min Chen
- From the Division of Medical Oncology, Department of Medicine and Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
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13
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Prurigo Nodularis as Initial Presentation of Metastatic Transitional Cell Carcinoma of the Bladder. J Urol 2002. [DOI: 10.1097/00005392-200208000-00048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Herrera Puerto J, Herrera Flores J, Barragán Casas JM, Galán Velasco JJ. [Cutaneous metastasis of a transitional-cell bladder carcinoma]. Actas Urol Esp 2002; 26:413-5. [PMID: 12189736 DOI: 10.1016/s0210-4806(02)72803-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Transitional cell of bladder carcinoma metastasizing to the skin is uncommon finding, generally appearing in the final stages such that occurred in our patient that indicated a poor prognosis. A lesion located in the pubic region and internal face of the left lower limb with at erythematous, indurated, and aggregated appearance was found. The histological examination of the specimen after cold biopsy demonstrated cutaneous metastasis from transitional cell carcinoma.
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