Efficacy and safety of gemcitabine monotherapy in an elderly patient with penile metastasis from bladder carcinoma: a case report

Abstract

We describe the case of an 85-year-old Japanese male with invasive urothelial carcinoma of the bladder treated with radiotherapy and the significant effects of gemcitabine monotherapy on subsequent metastases to the lungs, L5 vertebral body, and penis. The lung and L5 vertebral body metastases were diagnosed 3 months after radiotherapy and were treated with one course of gemcitabine and cisplatin chemotherapy. As the patient was unable to continue the chemotherapy, the chemotherapy was switched to two further courses of gemcitabine monotherapy, and he showed a significant response to the metastasis. The patient’s condition was good until he noticed a penile nodule that appeared 2.5 years after the radiotherapy. The penile tumor was pathologically confirmed as metastatic urothelial carcinoma. The patient received one additional course of gemcitabine monotherapy. At a 1-year follow-up examination, he was still alive and had responded completely to the treatment for the penile metastasis. Metastatic involvement of the penis is an exceptionally rare condition. It is important to consider the balance between the tolerability and efficacy of chemotherapy and that gemcitabine monotherapy might be acceptable in an elderly patient with metastatic urothelial carcinoma who is still in good physical condition. The findings in this case suggest that gemcitabine monotherapy may be one possible candidate for the treatment of metastatic urothelial carcinoma, even in patients aged 80 years or older.