Abstract
We report a rare case of a solitary adrenal metastasis from small cell carcinoma of the urinary bladder that was successfully treated with surgical resection. A 71-year-old man was suffering from bladder tamponade for hematuria. Computed tomography (CT) revealed a bladder tumor at the left wall. The patients underwent radical cystectomy. Histopathological results were obtained in small cell carcinoma of the bladder with muscle invasion. Thus, he received two courses of adjuvant etoposide and cisplatin chemotherapy, followed by the regimen for small cell lung cancer. Seven months after surgery, follow-up CT showed a gradually enlarged mass enhanced heterogeneously in the right adrenal gland. There was a solitary adrenal metastasis without any other metastasis; therefore, we performed right laparoscopic adrenalectomy. The patient has remained uneventful for four years after the adrenal gland surgery. For patients who have a solitary adrenal metastasis, adrenalectomy may provide a survival benefit.
Highlights
Small cell carcinoma of the bladder (SCCB) is exceedingly rare and accounts for less than 1% of all bladder carcinomas
It is rare that bladder carcinoma can cause a solitary adrenal metastasis, but it has been reported that surgical resection could improve survival [4]
We present a case of laparoscopic adrenalectomy as a treatment for solitary adrenal metastasis from SCCB, which was identified even after cystectomy and two courses of adjuvant etoposide and cisplatin (EP) chemotherapy
Summary
Small cell carcinoma of the bladder (SCCB) is exceedingly rare and accounts for less than 1% of all bladder carcinomas. Because SCCB is mostly diagnosed at an advanced stage and behaves aggressively, the prognosis of patients with SCCB is poor; overall survival at five years ranges from 8% to 25% [1,2,3]. SCCB is frequently managed by radical cystectomy with adjuvant chemotherapy, but there is no established treatment for the disease. It is rare that bladder carcinoma can cause a solitary adrenal metastasis, but it has been reported that surgical resection could improve survival [4]. We present a case of laparoscopic adrenalectomy as a treatment for solitary adrenal metastasis from SCCB, which was identified even after cystectomy and two courses of adjuvant etoposide and cisplatin (EP) chemotherapy
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