Abstract:
BACKGROUND:Non-muscle invasive bladder cancer (NMIBC) is usually treated with local therapy including transurethral resection of the bladder tumor and intravesical therapy depending on the stage of the tumor. NMIBC is a rarely a metastatic diseases with lymph node invasion in less of 10%. In the other hand meningeal carcinomatosis is a rare location for metastases with extremely poor outcomes. We described a case report of a patient presenting a metastatic disease to bones and meninges, several years after the treatment of NMIBC, which had been in complete response (CR) for 4 years after chemotherapy treatment. CASE PRESENTATION:A 63-years old men was treated by TURBT in 2008 for a high grade NMIBC, pT1b. Three years later he presented an acute binocular diplopy with right trochlear nerve paralysis, and labial hypoesthesia. Brain scan and MRI were performed finding a clivus infiltration and a pachymeningitis. A vertebral biopsy was performed finding an invasive carcinoma, CK7+/CK20+, TTF1-, PSA-, Thyroglobulin- and GATA3+. The metastatic event was in relation to the high grade NMIBC treated 3 years previously. Palliative chemotherapy was started with cisplatin gemcitabine. After 6 cycles and to date, 4 years later, the patient is therefore considered in complete response. CONCLUSION:Metastasis in non-muscle invasive urothelial carcinoma is rare. Meningeal carcinomatosis outcome is poor, usually appearing in widely metastatic and progressive cancers but also because most systemic agents fail to pass the blood-brain barrier and penetrate into the cerebrospinal fluid. We described an unexpected response with complete response after chemotherapy for meningeal carcinomatosis of non muscle invasive urothelial carcinoma.
journal_name
BMC Cancerjournal_title
BMC cancerauthors
Teyssonneau D,Daste A,Dousset V,Hoepffner JL,Ravaud A,Gross-Goupil Mdoi
10.1186/s12885-017-3309-2subject
Has Abstractpub_date
2017-05-11 00:00:00pages
323issue
1issn
1471-2407pii
10.1186/s12885-017-3309-2journal_volume
17pub_type
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