上尿路上皮癌伴鳞状分化的心脏转移。

IF 0.7 Q4 ONCOLOGY
Case Reports in Oncology Pub Date : 2025-05-08 eCollection Date: 2025-01-01 DOI:10.1159/000546330
Ahmad Al-Bitar, Ayla Kouli, Joudi Talaba, Mariah Azarpayk, Muhamad Al Tawil
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引用次数: 0

摘要

导读:上路尿路上皮癌占尿路上皮恶性肿瘤的5-10%,很少转移到远端部位,如心脏。病例介绍:本报告报告一例罕见的心脏转移病例,患者为62岁男性,有复杂的尿路上皮癌复发史。患者于1999年首次被诊断为膀胱癌,接受了多次手术切除和膀胱内治疗,2012年因难治性间变性肿瘤接受膀胱切除术。十年后,他出现右侧肾积水和血尿,促使行肾输尿管切除术,结果显示乳头状尿路上皮癌伴鳞状分化(pT3pNxMx)。尽管有积极的局部治疗,但在2023年发现了累及右心室心肌的心脏转移。全身化疗收效甚微,患者最终死于进行性心力衰竭。结论:尿路上皮癌的鳞状分化预示着侵袭性、耐药行为。膀胱切除术后延迟复发支持野区癌的概念,需要终生监测。一种罕见的心脏转移证实了血液扩散的可能性,并强调了改进辅助治疗的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiac Metastasis in Upper Tract Urothelial Carcinoma with Squamous Differentiation.

Introduction: Upper tract urothelial carcinoma, accounting for 5-10% of urothelial malignancies, rarely metastasizes to distant sites such as the heart.

Case presentation: This report describes a rare case of cardiac metastasis in a 62-year-old male with a complex history of recurrent urothelial carcinoma. Initially diagnosed with bladder cancer in 1999, the patient underwent multiple resections and intravesical therapies, followed by cystectomy in 2012 due to refractory anaplastic tumors. A decade later, he developed right-sided hydronephrosis and hematuria, prompting a nephroureterectomy, which revealed papillary urothelial carcinoma with squamous differentiation (pT3pNxMx). Despite aggressive local management, cardiac metastasis involving the right ventricular myocardium was identified in 2023. Systemic chemotherapy yielded minimal response, and the patient eventually succumbed to progressive cardiac failure.

Conclusion: Squamous differentiation in urothelial carcinoma predicts aggressive, treatment-resistant behavior. Delayed post-cystectomy recurrence supports the concept of field cancerization and necessitates lifelong surveillance. A rare cardiac metastasis confirms the hematogenous spread potential and underscores the need for improved adjuvant therapies.

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来源期刊
CiteScore
1.40
自引率
12.50%
发文量
151
审稿时长
7 weeks
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