Bladder Metastasis Research Articles

Pancreatic signet-ring cell carcinoma (the rare) with urinary bladder metastasis (the rarer).

Pancreatic signet-ring cell carcinoma (the rare) with urinary bladder metastasis (the rarer).

A SQUAMOUS CELL CARCINOMA OF THE UTERINE CERVIX RECURRING IN THE FORM OF AN ISOLATED BLADDER METASTASIS: A CASE REPORT AND REVIEW OF THE LITERATURE

Bladder cancer is the second most common urological cancer after prostate cancer, and bladder metastases are rare. We report the case of a 42-year-old female patient who underwent surgical treatment for cervical cancer 5 years ago and presented with a recurrence of her disease in the form of an isolated bladder tumor resembling primary bladder cancer. The diagnosis was confirmed by human papillomavirus (HPV) genotyping performed on the biopsy sample of the bladder tumor. The patient was treated with chemotherapy similar to that used for cervical cancer, with a favorable clinical and biological response.

Significant reduction in burden of metastatic disease by intermittent docetaxel therapy in a patient with castration-resistant prostate cancer.

Intermittent docetaxel therapy (IDT) is rarely used nowadays as a treatment option for men with metastatic castration-resistant prostate cancer (mCRPC) because of the widespread availability of androgen receptor axis-targeted therapy, which is less toxic. Therefore, there is limited information available on whether IDT has a clinical benefit in the treatment of men with mCRPC. This report describes the case of a 66-year-old man with a diagnosis of cT2N1M0 prostate cancer who underwent neoadjuvant combined androgen blockade and whole-pelvis radiation therapy. However, the tumor had progressed to mCRPC with metastasis to the bladder and a left pelvic lymph node within 2years. Docetaxel had been administered as first-line chemotherapy, and the patient achieved a complete response in terms of the bladder metastasis. Docetaxel was stopped after 15 cycles. When a durable response had been maintained for more than 2years, during which only androgen deprivation therapy was administered, the patient was switched to observation only. However, his prostate-specific antigen level gradually increased. Abiraterone was started as second-line therapy, during which there was a rapid increase in the PSA level. Computed tomography revealed further enlargement of the left pelvic lymph node, bladder metastasis, metastasis to the left common iliac lymph nodes, and several disseminated nodules around the bladder. Docetaxel was reintroduced as IDT for third-line therapy, and a complete response was achieved for all metastases, with the exception of the metastasis in the left pelvic lymph node. Thus far, the patient has survived for more than 7years after starting docetaxel as first-line therapy for mCRPC. IDT is potentially useful in a subgroup of patients with mCRPC and could achieve long-term survival. Comprehensive genomic profiling may help physicians to select patients with mCRPC who are more likely to benefit from docetaxel than other systemic therapy.

Description of a case, bladder metastasis from breast carcinoma

Breast cancer is the main cause of cancer-related death in women and almost all related deaths occur due to metastasis. The most frequent places of metastasis are lymph nodes, bone, lung, liver, and central nervous system. Bladder metastasis are very rare, being described in only 7% of autopsy studies. Besides being uncommon, most cases of secondary bladder involvement occur as a result of disseminated disease, being the solitary bladder metastasis sporadically reported.This article presents the case of a woman with a history of invasive lobular breast carcinoma who, 18 months after diagnosis, presents herself with complaints of urinary urgency and urinary incontinence. The requested complementary exams revealed a voluminous bladder mass and the anatomopathological study was compatible with a metastatic lesion.

Bladder Metastatic Breast Cancer Presenting Initially with Lower Urinary Tract Symptoms: A Rare Case Report

Introduction: Breast cancer (BC) is the most frequently diagnosed malignancy (25% of all cancers) and the leading cause of cancer-related death in women; death is mainly attributed to the metastatic spread of the primary tumor. On the other hand, secondary tumors of the bladder are rare, representing 2% of all bladder neoplasms. Breast cancer rarely spreads to the urinary bladder. Patients in almost all previous reports have been diagnosed with BC several months before the bladder metastasis (BM) was discovered. Case Presentation: A 67-year-old woman presented with irritative bladder symptoms with no history suggestive of BC. Normal breast examination and normal laboratory investigations with Breast Imaging Reporting and Data System 1 (BI-RADS 1) in mammographic evaluation challenged the pathological findings of the bladder biopsy that was positive for metastatized BC to the bladder. Conclusions: Metastatic BC may rarely initially present with irritative lower urinary symptoms and absent clinical and radiological features of BC-but positive histopathological findings.

Clinical and pathological characteristics of metastatic tumors to the urinary bladder

Metastatic carcinoma to the urinary bladder is a rare and under-recognized condition in surgical pathology. In this study, we identified 8 cases of true bladder metastasis at our institution in the past 20 years, excluding secondary tumors via direct extension or serosal implantation. The most common tumor type is malignant melanoma (3/8), followed by clear cell renal cell carcinoma (2/8), adenocarcinoma of the gastrointestinal tract (2/8), and breast invasive lobular carcinoma (1/8). There are 6 cases of endoscopically exophytic metastasis and 2 cases of diffuse metastasis, commensurate with 6 patients with hematuria and 2 patients with urinary obstruction as respective clinical symptoms. Exophytic bladder metastasis usually presents with similar clinical features as urothelial carcinoma, while diffuse metastasis often masquerades as a urinary tract infection. In the latter circumstance, a markedly thickened bladder wall discerned via imaging study is the best indication for the bladder biopsy to circumvent the misdiagnosis. Histologically, the metastatic tumors can also mimic conventional urothelial carcinoma or its histological variants, and thus pose a potential diagnostic challenge to pathologists. The lack of an in situ component in primary bladder cancer may hint at bladder metastasis. Accurate diagnosis of bladder metastasis requires heightened alertness to this rare condition in addition to a multidisciplinary approach.

Urinary bladder metastasis from primary lung cancer, a rare and challenging diagnosis: a case report.

The authors describe the case followed for lung adenocarcinoma with an exceptional metastatic site, which is the bladder. A computed tomography scan showed a left suprahilar bronchial tumor with pleurisy (Fig. 1A), which biopsies concluded to a moderately differentiated adenocarcinoma. The patient is treated with palliative cisplatin-based chemotherapy. And died 11 months after diagnosis. Bladder metastases are rare, representing only 2% of all malignant bladder tumors. Metastatic lesions of the bladder are generally revealed by hematuria. Confirmation of bladder invasion is immunohistochemical, facilitated by knowledge of the primitive. In the presence of any adenocarcinoma of the bladder, a thoracic-abdominal-pelvic computed tomography scan must be requested in search of a primary extra-vesical cancer who can facilitate the diagnosis.

Bladder metastasis from epidermal growth factor receptor mutant lung cancer: A case report

Bladder metastasis from lung cancer with epidermal growth factor receptor (EGFR) mutation is extremely rare. Here, we report a case of bladder metastasis from lung adenocarcinoma with EGFR mutation. A 53-year-old female patient was diagnosed with advanced lung adenocarcinoma with EGFR exon 19 deletion. Multiple nodules on the bladder wall were found by regular examination of the pelvic cavity through computed tomography during targeted therapy. Further cystoscopy and histological examination of bladder biopsy tissues confirmed the bladder metastasis from lung adenocarcinoma. In addition, genetic analysis of the bladder metastasis revealed EGFR T790M mutation. The patient achieved a good response to a third-generation EGFR tyrosine kinase inhibitor. During routine follow-up of lung cancer patients, imaging examination of the pelvic cavity should be performed to avoid missing bladder metastasis. The ultimate diagnosis of bladder metastasis sill depends on the pathological result of biopsy tissues.

Severe hematuria in a patient receiving bevacizumab and pembrolizumab for metastatic cervical cancer: a case report

BackgroundBevacizumab is a monoclonal antibody drug targeting Vascular Endothelial Growth Factor (VEGF), which binds to VEGF receptors to inhibit vascular endothelial cell proliferation and angiogenesis, thus inhibiting tumorigenesis. Pembrolizumab is a monoclonal antibody that can bind to the programmed death-1 (PD-1) receptor, which can block the binding of the PD-1 receptor to its ligands PD-L1 and PD-L2, and release PD-1 pathway-mediated suppression of immune responses. By blocking the activity of PD-1, the purpose of inhibiting tumor growth is achieved.Case presentationWe report a severe hematuria of bevacizumab plus pembrolizumab, in a 58-year-old woman with metastatic cervical cancer. After three cycles every three weeks of consolidation chemotherapy (carboplatin, paclitaxel, bevacizumab) and following three cycles consolidation chemotherapy (carboplatin, paclitaxel, bevacizumab, pembrolizumab), the patient presented a worsening state. Manifested as massive gross hematuria with blood clots. After stopping chemotherapy, cefoxitin, tranexamic acid and hemocoagulase atrox therapy was administered resulting in rapid clinical improvement. The patient was a cervical cancer with bladder metastasis that increases the risk of development of hematuria. Inhibition of VEGF, which has anti-apoptotic, anti-inflammatory, and pro-survival influences on endothelial cells, weakens their regenerative capacity and increases expression of proinflammatory genes leading to weakened supporting layers of blood vessels and, hence, to damaged vascular integrity. In our patient, the development of hematuria may result from the anti-VEGF effect of bevacizumab. In addition, pembrolizumab may also cause bleeding, and the mechanism of bleeding caused by pembrolizumab is currently unclear, which may be related to immune mediation.ConclusionTo our knowledge, this is the first case reporting on the development of severe hematuria during bevacizumab plus pembrolizumab treatment, which should alert the clinicians in case of bleeding adverse events onset in older patients under bevacizumab plus pembrolizumab therapy.

Bladder Melanoma

Metastatic bladder tumors constitute <5% of all bladder tumors, however metastatic malignant melanoma of the urinary bladder is very rare. The determination of the original focus of metastatic melanomas in urinary bladder is convenient in some cases, where the primary focus is already known from patients reported clinical history. In the presenting case, we report a case of a patient with ocular melanoma with bladder metastasis. To our knowledge, this is the first described case in Morocco. The patient underwent a cystoscopy with Trans Urethral Resection of the bladder, immunohistochemical analysis revealed that the tumor cells were positive for Melan-A.

Multiple Cutaneous Nodules as Clinical Harbinger of Gallbladder Adenocarcinoma: A Case Report

Introduction: Cutaneous metastasis is defined as invasion of the skin by malignant cells originating elsewhere in the body. Cutaneous metastasis of Adenocarcinoma gall bladder is extremely rare. The skin can be involved simultaneously or metachronously with the primary tumour. Cutaneous metastases may present as a clinical harbinger to an otherwise difficult to diagnose primary Adenocarcinoma gallbladder. Case presentation: A young male presented with multiple nodules on scalp, trunk and limbs along with fever, weight loss and lymphadenopathy. Histopathologic examination of the nodule revealed a malignant infiltrating glandular neoplasm in dermis, consistent with metastatic adenocarcinoma with intestinal metaplasia on immunohistochemistry. Radiological investigations further confirmed the primary tumour in gall bladder with metastases in liver and lymph nodes. Unfortunately, the patient succumbed to his disease. Discussion: Gallbladder adenocarcinoma is the most commonly seen tumour of the biliary tract. Skin involvement in malignancy helps determine the treatment course and has inevitable prognostic significance. Conclusion: We herein report multiple cutaneous nodules as a remote manifestation of gallbladder adenocarcinoma. Biopsy of the skin lesion was easy to perform and quite reliably guided us towards the diagnosis of the primary tumour which would have been very difficult to diagnose otherwise.

From women to women-hematuria during therapy for metastatic breast cancer, what to suspect and when to be alarmed; Bladder metastasis from breast cancer-our experience and a systematic literature review.

Breast cancer is one of the most important causes of premature mortality in women worldwide. Around 12% of breast cancer patients will develop metastatic disease, a stage associated with poor prognosis, and only 26% of patients are likely to survive for at least 5 years after being diagnosed. Although the most common sites where breast cancer tends to spread are bones, lungs, brain, and liver, it is important that physicians consider other less frequent organs and viscera, like the bladder, as a target destination. In this article we report our experience with this rare form of metastases and a systematic literature review. We analyzed case reports, case series, and review articles present in PubMED/MEDLINE up to March 2022. We excluded the nonrelevant articles, editorials, letters to the editor, and articles written in other languages. We identified a total of 302 articles, with 200 articles being removed before screening; therefore, the total number of abstracts reviewed was 102. Fifty-five articles were excluded before full text review because they did not meet the inclusion criteria, and one article was not retrievable. Therefore, we included a total of 45 articles in this review. The intention of this review is to highlight the importance of the early detection of bladder metastases and to facilitate the diagnostic process for the responsible physician. The most common signs and symptoms and breast cancer subtype associated with bladder metastases, as well as overall survival after their detection, were all assessed. Bladder metastases from metastatic breast cancer are prevalent in the invasive, lobular breast cancer subtype; most patients present with hematuria (39.5%) and the relative 5-year survival rate is 2%. The main limitations of this review are the low number of cases reported in the literature, clinical and pathological differences between the individual cases, and absence of the control group. This study was not funded.

Abstract 2417: Elucidating the role of SMARCB1 in bladder cancer progression and metastasis

Abstract Bladder cancer (BLCA) is the second most common urological malignancy in the US and is usually not curable at an advanced stage. The transcriptomic profiling data of bladder cancer revealed that 64% of BLCA patients have frequent dysregulation of the components of the SWI/SNF, a chromatin remodeling complex. Alterations in chromatin remodeling genes have been previously implicated in human oncogenesis. SMARCB1/INI1 is one of the critical core components of the SWI/SNF complex. In this study, we demonstrate that primary BLCA patients harboring SMARCB1 loss strongly associate with worse survival. Specifically, the biallelic inactivation of the SMARCB1 (SMARCB1 knockout (KO)) in BLCA cell lines resulted in the emergence of aggressive tumor growth leading to soft tissue metastasis to lungs, liver, kidney, and intestine in vivo. Mechanistic studies revealed that IL-6- STAT3 axis is upregulated in SMARCB1 KO BLCA cells. Our data suggest that the STAT3 specific inhibitor, inhibits invasive potential of SMARCB1 KO cells suggesting potential therapeutic efficacy for STAT3 inhibitor to treat subsets of BLCA harboring SMARCB1 loss. In addition, we identified a unique transcriptional signature activated upon SMARCB1 loss, which is predictive of poor patient outcome in BLCA, and hence may be clinically valuable. Bladder cancer (BLCA) is the second most common urological malignancy in the US and is usually not curable at an advanced stage. The transcriptomic profiling data of bladder cancer revealed that 64% of BLCA patients have frequent dysregulation of the components of the SWI/SNF, a chromatin remodeling complex. Alterations in chromatin remodeling genes have been previously implicated in human oncogenesis. SMARCB1/INI1 is one of the critical core components of the SWI/SNF complex. In this study, we demonstrate that primary BLCA patients harboring SMARCB1 loss strongly associate with worse survival. Specifically, the biallelic inactivation of the SMARCB1 (SMARCB1 knockout (KO)) in BLCA cell lines resulted in the emergence of aggressive tumor growth leading to soft tissue metastasis to lungs, liver, kidney, and intestine in vivo. Mechanistic studies revealed that IL-6- STAT3 axis is upregulated in SMARCB1 KO BLCA cells. Our data suggest that the STAT3 specific inhibitor, inhibits invasive potential of SMARCB1 KO cells suggesting potential therapeutic efficacy for STAT3 inhibitor to treat subsets of BLCA harboring SMARCB1 loss. In addition, we identified a unique transcriptional signature activated upon SMARCB1 loss, which is predictive of poor patient outcome in BLCA, and hence may be clinically valuable. Citation Format: Chandra Sekhar Amara, Karthik Reddy Reddy, Yuntao Yang, Badrajee Waduge Danthasinghe, Allison Bellman, Andrea B. Apollo, David J. Shih, Leomar Ballester, Pavlos Msaouel, Wenjin J. Zheng, Matthew J. Ellis, Seth P. Lerner, Arun Sreekumar, Shyam M. Kavuri, Nagireddy Putluri. Elucidating the role of SMARCB1 in bladder cancer progression and metastasis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2417.

Case of metachronous clear cell bladder metastasis on low risk localized renal cell carcinoma patient.

IntroductionRenal cell carcinoma (RCC) is well known for its ability to metastasize into different organs. However, the management of metachronous RCC is still not yet standardized.Case PresentationA 62 years old man was presented with haematuria for the last 2 months. CT scan revealed bladder mass with a size of 2,5 cm and underwent en-bloc resection of bladder mass. The histopathological result showed non-muscle-invasive bladder clear cell renal carcinoma. The patient had a history of left nephrectomy in 2017 and meningioma mass metastasectomy in 2020 with the same histopathological origin.ConclusionBladder metastasis of RCC can be treated by endoscopic surgical intervention.

VRK1 Predicts Poor Prognosis and Promotes Bladder Cancer Growth and Metastasis In Vitro and In Vivo.

Bladder cancer (BC) is one of the most common malignant tumors in the urinary system with growing morbidity and diagnostic rate in recent years. Therefore, identifying new molecular biomarkers that inhibit the progression of bladder cancer is needed for developing further therapeutics. This study found a new potential treatment target: vaccinia-related kinase 1 (VRK1) and explored the function and mechanism of VRK1 in the development of bladder cancer. First, TCGA database and tissue microarray analysis showed that VRK1 was significantly upregulated in bladder cancer. Kaplan–Meier survival analysis indicates that the OS and PFS of the VRK1 high expression group were significantly lower than the VRK1 low expression group (p = 0.002, p = 0.005). Cox multi-factor analysis results show that VRK1 expression is an independent risk factor affecting tumor progress. The maximum tumor diameter, staging, and adjuvant chemotherapy also have a certain impact on tumor progression (p < 0.05). In internal validation, the column C index is 0.841 (95% CI, 0.803–0.880). In addition, cell functional studies have shown that VRK1 can significantly inhibit the proliferation, migration, and invasiveness of bladder cancer cells. In vivo, nude mice transplanted tumors further prove that low VRK1 can significantly inhibit the proliferation capacity of bladder cancer cells. In summary, VRK1 expression is significantly related to the staging, grade, and poor prognosis of patients with bladder cancer. At the same time, in vivo and in vitro experiments have shown that downregulation of VRK1 can significantly inhibit the proliferation of bladder cancer cells. These findings provide a basis for using VRK1 as a potential therapeutic target for patients with bladder cancer.

Bladder metastasis with additional metastases in multiple other organs 4 years after radical nephrectomy for clear cell renal cell carcinoma: a case report and review of the literature\xa0

BackgroundRenal cell carcinoma rarely metastasizes to the bladder, and its biological behavior is not yet fully understood.Case presentationIn our case (54-year-old Japanese woman), computed tomography evaluation suggested the presence of a bladder metastasis, associated with additional metastases in the lungs, mediastinal lymph nodes, ribs, and renal bed, 4 years after radical nephrectomy for renal cell carcinoma. The histological findings of the metastatic bladder tumor were consistent with those of clear cell carcinoma. The mediastinal lymph node, rib, and renal bed metastases responded to treatment with an immune checkpoint inhibitor administered for 12 months after surgery for the bladder and lung metastases. In patients with bladder metastasis, absence of metastases in other organs and an interval of more than 1 year after nephrectomy are known to be favorable prognostic factors. Interestingly, in our case, the bladder metastasis was detected more than 1 year after nephrectomy, which was a favorable factor, but there were also metastases in other organs, which was an unfavorable factor. Therefore, we reviewed the literature, including that pertaining to targeted therapy and immune checkpoint inhibitor therapy published in the last two decades, to analyze the clinical significance of the presence of additional metastasis in other organs in renal cell carcinoma (clear cell type, which is the predominant subtype) patients with bladder metastasis.ConclusionsPatients with bladder metastasis after nephrectomy for renal cell carcinoma also having metastases in other organs may respond to targeted therapy and immune checkpoint inhibitor therapy. This may suggest that the interval to relapse in the bladder after nephrectomy may be a more important prognostic factor than the presence of synchronous metastases in other organs.

Metastasis of a widespread malignant melanoma in the bladder and the upper urinary tract: A case report

The urinary tract is an uncommon site of metastatic melanoma. Herein, we discuss a rare case of melanoma with metastatic involvement of the bladder and upper urinary tract and review its surgical management based on prognosis. We report the case of a 38-year-old male with biopsy-proven ureteral and bladder metastasis of cutaneous melanoma. The management of these metastases is challenging. Endoscopic treatments allowed to control local symptoms without associated serious adverse events. Radical surgical operations such as nephroureterectomy could be envisaged for completely resectable tumors in a patient responding well to systemic therapies.

Case Report: Metastatic Signet-Ring-Cell Carcinoma of the Bladder From Breast Invasive Lobular Carcinoma Detected by Computed Tomography

Secondary bladder tumors are relatively rare among all bladder tumors, while bladder metastases from breast cancer have been rarely reported. Furthermore, signet-ring differentiation may appear in the metastases from a breast invasive lobular carcinoma regardless of whether the primary breast tumor had signet-ring cells, which may cause diagnostic uncertainty. We report a case of a 55-year-old female patient with diffuse bladder thickening as the chief complaint and no specific clinical manifestations. While the cystoscopy showed multiple scattered red protuberances, the biopsy suggested signet-ring-cell carcinoma. The gastroscopy results suggested poorly differentiated adenocarcinoma with signet-ring cells. Considering the patient’s history of invasive lobular carcinoma of the breast, chronic myeloid leukemia, and metastatic endometrial carcinoma from the breast, we performed an immunohistochemical analysis and the results indicated that signet-ring-cell carcinomas of the stomach and bladder originated from the invasive lobular carcinoma of the breast. We performed positron emission tomography/computed tomography and the results showed that there were multiple bone metastases already present. This was the first English case report of invasive lobular carcinoma of the breast metastasizing to the uterus, stomach, bladder, and bones with multiple signet-ring-cell variations. This study shares our reasons for misdiagnosing and opinions on diagnosing and treating for this kind of cases.

Bladder Metastasis of Breast Cancer: A Case Report and Review

Breast cancer is the most frequently diagnosed malignancy in women in Morocco. The most common sites for breast cancer metastasis includes lungs, liver, lymphatic nodes, bones, and brain and skin while other organs are less frequently involved. We describe a rare case of a patient with breast cancer who presented with urinary bladder metastasis as a late complication of her illness.

CircKDM4C enhances bladder cancer invasion and metastasis through miR-200bc-3p/ZEB1 axis

Circular RNAs (circRNAs) play essential roles in human bladder cancer (BCa) development, however, unusual expression patterns and functional dysfunction of circRNAs in BCa have not been evaluated. In this study, we validated that circKDM4C (hsa_circ_0001839), derived from the KDM4C gene, is elevated in BCa cell lines as well as tissues. Functionally, overexpression of circKDM4C significantly enhances, and silencing of circKDM4C suppresses migration and invasion capabilities of BCa cells. Mechanistically, circKDM4C can directly interact with miR-200b-3p and miR-200c-3p as a miRNA sponge, which enhances the expression of ZEB1 and promotes mesenchymal phenotype. Conclusively, our findings indicate that circKDM4C may act as a pro-oncogenic factor in BCa invasion and metastasis via the circKDM4C/miR-200bc-3p/ZEB1 axis, which is a potential biomarker or therapeutic target for bladder cancer.