Leptomeningeal Carcinomatosis in Urothelial Carcinoma of the Urinary Bladder: A Report of a Patient with a Fulminant Course Who Died of Cancer after Definitive Therapies.

Case Reports in Urology Pub Date : 2021-04-30 eCollection Date: 2021-01-01 DOI:10.1155/2021/5543939
Masayuki Tomioka, Makoto Kawase, Daiki Kato, Manabu Takai, Koji Iinuma, Kengo Horie, Keita Nakane, Natsuko Suzui, Tatsuhiko Miyazaki, Takuya Koie
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引用次数: 2

Abstract

A 45-year-old Japanese man visited a community hospital with the chief complaint of asymptomatic macrohematuria. He was diagnosed with muscle-invasive bladder cancer (MIBC), and he received intra-arterial chemotherapy followed by radiation therapy at another institution. Twenty-eight months after chemoradiotherapy, magnetic resonance imaging (MRI) revealed MIBC recurrence. After neoadjuvant chemotherapy, robot-assisted radical cystectomy was performed. Pathological examination indicated high-grade urothelial carcinoma with lymphovascular invasion, a positive surgical margin, and skip lesions of cancer cells in the perivesical adipose tissue. Three months after surgery, he was brought to our hospital in an ambulance with the chief complaint of rotatory vertigo and was speaking inarticulately. Head and whole spine MRI revealed meningeal metastasis along both the vestibulocochlear nerves and cauda equina. Analysis of the cerebrospinal fluid revealed malignant cells. The patient was diagnosed with leptomeningeal carcinomatosis originating from the MIBC. He received whole-brain radiotherapy followed by the administration of pembrolizumab. Unfortunately, the patient's condition quickly deteriorated, and he died of cancer 4 months after surgery.

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尿路上皮性膀胱癌的轻脑膜癌:一名患者在经过明确的治疗后死于癌症的暴发性病程。
一名45岁日本男子以无症状大血尿主诉到社区医院就诊。他被诊断为肌肉浸润性膀胱癌(MIBC),并在另一家机构接受了动脉化疗和放射治疗。放化疗28个月后,磁共振成像(MRI)显示MIBC复发。新辅助化疗后,行机器人辅助根治性膀胱切除术。病理检查显示高级别尿路上皮癌伴淋巴血管浸润,手术切缘阳性,膀胱周围脂肪组织癌细胞跳跃性病变。手术后三个月,他被救护车送到我们医院,主诉为旋转性眩晕,说话不清楚。头部和整个脊柱MRI显示脑膜沿前庭耳蜗神经和马尾转移。脑脊液分析显示有恶性细胞。该患者被诊断为起源于MIBC的小脑膜癌。他接受全脑放疗,随后给予派姆单抗。不幸的是,病人的病情迅速恶化,他在手术后4个月死于癌症。
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