Metastatic small cell bladder cancer treated with sequential systemic therapy including pembrolizumab and amrubicin: A case report

Introduction

Small cell bladder cancer is a relatively rare tumor, representing <1% of all bladder tumors. Amrubicin monotherapy is used as second-line treatment for small cell lung cancer in Japan.

Case presentation

A 79-year-old woman presented with gross hematuria and was diagnosed with small cell bladder cancer (T2 or higher). Neoadjuvant chemotherapy with etoposide and cisplatin resulted in a partial response. Robot-assisted radical cystectomy was performed, and radical resection was achieved. As we identified metastasis in the pleura 1 year later, we administered carboplatin and etoposide, which resulted in a partial response. Although pembrolizumab was initiated as maintenance therapy, it was not effective. Amrubicin was given as third-line therapy, and stable disease was achieved without serious adverse effect for 6 months.

Conclusion

Although there is no established treatment for metastatic small cell bladder cancer, the current case report suggests the effectiveness of amrubicin in this setting.

Cut-to-the-light technique is useful for complete obstruction of a Wallace ureteroileal anastomosis

Introduction

Obstruction of a ureteroileal anastomosis after urinary diversion is an unpleasant situation for patients and clinicians alike.

Case presentation

A 48-year-old man who underwent a radical cystectomy for muscle-invasive bladder cancer and urinary diversion using the Wallace technique complained of right back pain. Computed tomography showed right hydronephrosis. Cystoscopy via the ileal conduit revealed complete obstruction of the ureteroileal anastomosis. We performed a bilateral approach (antegrade and retrograde) to use the cut-to-the-light technique. A guidewire and 7Fr single J catheter could be inserted.

Conclusion

The cut-to-the-light technique was useful for complete obstruction of the ureteroileal anastomosis, the length of which was <1 cm. Herein, we report on the cut-to-the-light technique with a literature review.