Leptomeningeal Carcinomatosis in Urothelial Carcinoma of the Urinary Bladder: A Report of a Patient with a Fulminant Course Who Died of Cancer after Definitive Therapies

A 45-year-old Japanese man visited a community hospital with the chief complaint of asymptomatic macrohematuria. He was diagnosed with muscle-invasive bladder cancer (MIBC), and he received intra-arterial chemotherapy followed by radiation therapy at another institution. Twenty-eight months after ch...

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Main Authors: Masayuki Tomioka, Makoto Kawase, Daiki Kato, Manabu Takai, Koji Iinuma, Kengo Horie, Keita Nakane, Natsuko Suzui, Tatsuhiko Miyazaki, Takuya Koie
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Urology
Online Access:http://dx.doi.org/10.1155/2021/5543939
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author Masayuki Tomioka
Makoto Kawase
Daiki Kato
Manabu Takai
Koji Iinuma
Kengo Horie
Keita Nakane
Natsuko Suzui
Tatsuhiko Miyazaki
Takuya Koie
author_facet Masayuki Tomioka
Makoto Kawase
Daiki Kato
Manabu Takai
Koji Iinuma
Kengo Horie
Keita Nakane
Natsuko Suzui
Tatsuhiko Miyazaki
Takuya Koie
author_sort Masayuki Tomioka
collection DOAJ
description A 45-year-old Japanese man visited a community hospital with the chief complaint of asymptomatic macrohematuria. He was diagnosed with muscle-invasive bladder cancer (MIBC), and he received intra-arterial chemotherapy followed by radiation therapy at another institution. Twenty-eight months after chemoradiotherapy, magnetic resonance imaging (MRI) revealed MIBC recurrence. After neoadjuvant chemotherapy, robot-assisted radical cystectomy was performed. Pathological examination indicated high-grade urothelial carcinoma with lymphovascular invasion, a positive surgical margin, and skip lesions of cancer cells in the perivesical adipose tissue. Three months after surgery, he was brought to our hospital in an ambulance with the chief complaint of rotatory vertigo and was speaking inarticulately. Head and whole spine MRI revealed meningeal metastasis along both the vestibulocochlear nerves and cauda equina. Analysis of the cerebrospinal fluid revealed malignant cells. The patient was diagnosed with leptomeningeal carcinomatosis originating from the MIBC. He received whole-brain radiotherapy followed by the administration of pembrolizumab. Unfortunately, the patient’s condition quickly deteriorated, and he died of cancer 4 months after surgery.
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publishDate 2021-01-01
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spelling doaj-art-65a9c11e70d34880aac8d143611482462025-08-20T03:34:14ZengWileyCase Reports in Urology2090-696X2090-69782021-01-01202110.1155/2021/55439395543939Leptomeningeal Carcinomatosis in Urothelial Carcinoma of the Urinary Bladder: A Report of a Patient with a Fulminant Course Who Died of Cancer after Definitive TherapiesMasayuki Tomioka0Makoto Kawase1Daiki Kato2Manabu Takai3Koji Iinuma4Kengo Horie5Keita Nakane6Natsuko Suzui7Tatsuhiko Miyazaki8Takuya Koie9Department of Urology, Gifu University Graduate School of Medicine, Gifu, JapanDepartment of Urology, Gifu University Graduate School of Medicine, Gifu, JapanDepartment of Urology, Gifu University Graduate School of Medicine, Gifu, JapanDepartment of Urology, Gifu University Graduate School of Medicine, Gifu, JapanDepartment of Urology, Gifu University Graduate School of Medicine, Gifu, JapanDepartment of Urology, Gifu University Graduate School of Medicine, Gifu, JapanDepartment of Urology, Gifu University Graduate School of Medicine, Gifu, JapanDepartment of Pathology, Gifu University Graduate School of Medicine, Gifu, JapanDepartment of Pathology, Gifu University Graduate School of Medicine, Gifu, JapanDepartment of Urology, Gifu University Graduate School of Medicine, Gifu, JapanA 45-year-old Japanese man visited a community hospital with the chief complaint of asymptomatic macrohematuria. He was diagnosed with muscle-invasive bladder cancer (MIBC), and he received intra-arterial chemotherapy followed by radiation therapy at another institution. Twenty-eight months after chemoradiotherapy, magnetic resonance imaging (MRI) revealed MIBC recurrence. After neoadjuvant chemotherapy, robot-assisted radical cystectomy was performed. Pathological examination indicated high-grade urothelial carcinoma with lymphovascular invasion, a positive surgical margin, and skip lesions of cancer cells in the perivesical adipose tissue. Three months after surgery, he was brought to our hospital in an ambulance with the chief complaint of rotatory vertigo and was speaking inarticulately. Head and whole spine MRI revealed meningeal metastasis along both the vestibulocochlear nerves and cauda equina. Analysis of the cerebrospinal fluid revealed malignant cells. The patient was diagnosed with leptomeningeal carcinomatosis originating from the MIBC. He received whole-brain radiotherapy followed by the administration of pembrolizumab. Unfortunately, the patient’s condition quickly deteriorated, and he died of cancer 4 months after surgery.http://dx.doi.org/10.1155/2021/5543939
spellingShingle Masayuki Tomioka
Makoto Kawase
Daiki Kato
Manabu Takai
Koji Iinuma
Kengo Horie
Keita Nakane
Natsuko Suzui
Tatsuhiko Miyazaki
Takuya Koie
Leptomeningeal Carcinomatosis in Urothelial Carcinoma of the Urinary Bladder: A Report of a Patient with a Fulminant Course Who Died of Cancer after Definitive Therapies
Case Reports in Urology
title Leptomeningeal Carcinomatosis in Urothelial Carcinoma of the Urinary Bladder: A Report of a Patient with a Fulminant Course Who Died of Cancer after Definitive Therapies
title_full Leptomeningeal Carcinomatosis in Urothelial Carcinoma of the Urinary Bladder: A Report of a Patient with a Fulminant Course Who Died of Cancer after Definitive Therapies
title_fullStr Leptomeningeal Carcinomatosis in Urothelial Carcinoma of the Urinary Bladder: A Report of a Patient with a Fulminant Course Who Died of Cancer after Definitive Therapies
title_full_unstemmed Leptomeningeal Carcinomatosis in Urothelial Carcinoma of the Urinary Bladder: A Report of a Patient with a Fulminant Course Who Died of Cancer after Definitive Therapies
title_short Leptomeningeal Carcinomatosis in Urothelial Carcinoma of the Urinary Bladder: A Report of a Patient with a Fulminant Course Who Died of Cancer after Definitive Therapies
title_sort leptomeningeal carcinomatosis in urothelial carcinoma of the urinary bladder a report of a patient with a fulminant course who died of cancer after definitive therapies
url http://dx.doi.org/10.1155/2021/5543939
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