REGRESSION OF METASTATIC TRANSITIONAL CELL CARCINOMA IN RESPONSE TO TAMOXIFEN

Abstract

which is associated with limited response rates and significant toxicity. In contrast, hormonal therapy in oncology is well tolerated but generally restricted to tumors that express endocrine receptors. We describe a case of proved metastatic transitional cell carcinoma, which is not normally considered to be hormone sensitive, in which treatment with tamoxifen led to resolution of cutaneous deposits. CASE REPORT A 72-year-old man underwent radical cystoprostatectomy with urinary diversion by ileal conduit after progression of previously superficial bladder transitional cell carcinoma. Preoperative staging investigations indicated no evidence of extravesical disease. Histopathological analysis of the resected specimen confirmed pT3bN0G3 transitional cell carcinoma with clear resection margins. Two nodules developed adjacent to the laparotomy wound 6 months postoperatively. Excision biopsy of 1 lesion confirmed metastatic transitional cell carcinoma. The disease appeared to be progressive, as by 8 months postoperatively another 2 nodules had developed close to the wound. The patient also complained of painful gynecomastia, the origin of which was uncertain, and was treated with 10 mg. tamoxifen daily. The abdominal wall nodules were absent 3 months later. Clinical examination and cross-sectional imaging have shown no evidence of residual or recurrent disease. DISCUSSION