Abstract
Plasmacytoid bladder cancer is a rare variant of transitional cell carcinoma. A 57-year-old man was referred to our institution for management of invasive transitional cell carcinoma diagnosed at a peripheral hospital. His complaints were of vague lower abdominal pain with associated urgency and frequency requiring oxybutynin. Metastatic workup was negative and was subsequently scheduled for a radical cystectomy. Routine colonoscopy 3 weeks prior to surgery was negative. Intraoperatively, he was found to have metastatic urothelial cancer involving the cecum and multiple metastatic deposits within the mesentery of the small intestines. He underwent a palliative cystectomy with ileal conduit formation. Final pathology revealed metastatic plasmacytoid variant of urothelial cancer. Histology and immunohistochemistry were compatible with plasmacytoid variant of urothelial cancer. Here we present our case of this rare variant of urothelial cancer with a review of its characteristics.
Highlights
Bladder cancer is the 4th most common malignancy in males. It most commonly exists as epithelial tumor where 90% of cases are transitional cell carcinoma with a papillary appearance
In recent decades multiple variants of this epithelial tumor have been described, the significance of which lies in the impact it has on prognosis and approach to management
We describe plasmacytoid variant of transitional cell carcinoma in a 57-year-old man who was referred to our institution for further management
Summary
Bladder cancer is the 4th most common malignancy in males It most commonly exists as epithelial tumor where 90% of cases are transitional cell carcinoma with a papillary appearance. We describe plasmacytoid variant of transitional cell carcinoma in a 57-year-old man who was referred to our institution for further management. Case Presentation A 57-year-old French Canadian male presented with gross hematuria and worsening lower urinary tract symptoms. He was known for a history of recurrent superficial TCC refractory to two induction courses of BCG. Final pathology revealed muscle-invasive highgrade urothelial carcinoma of the bladder with plasmacytoid features penetrating through the entire bladder wall and into the serosa (Figure 1). He was discharged 10 days post operatively. He received postoperative systemic chemotherapy (gemcitabine/cisplatin); he passed away within 6 months due to rapid progression of disease
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