Abstract

A 69-year-old man was referred to our hospital with chief complaints of urinary incontinence, pollakiuria, thin stools and edema of the left lower extremity. Computed tomography and magnetic resonance imaging revealed bilateral hydronephrosis, thickening of the rectal and posterolateral bladder walls, and enlargement of the left obturator lymph nodes, suggesting metastasis. The carcinoembryonic antigen and carbohydrate antigen 19-9 levels were 5.6 ng/ml and 460.1 U/ml, respectively. A transurethral bladder biopsy revealed grade 2 urothelial carcinoma with glandular differentiation. A transrectal needle biopsy suggested cancer infiltration of the rectal wall and an annular rectal constriction caused by an infiltrating bladder cancer was diagnosed. Three courses of gemcitabine and cisplatin chemotherapy were administered and demonstrated good efficacy.

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