Metastatic non-muscle invasive bladder cancer with meningeal carcinomatosis: case report of an unexpected response

BMC Cancer

Case Report

Marine Gross-Goupil¹  Diego Teyssonneau¹  Alain Ravaud²  Amaury Daste²  Jean-Luc Hoepffner³  Vincent Dousset⁴ 

[1] Department of Medical Oncology, Saint-André hospital, University Hospital-CHU Bordeaux, 1 Rue Jean Burguet, 33000, Bordeaux, France;Department of Medical Oncology, Saint-André hospital, University Hospital-CHU Bordeaux, 1 Rue Jean Burguet, 33000, Bordeaux, France;University of Bordeaux, Bordeaux, France;Department of Urology, Clinique Saint-Augustin, Bordeaux, France;University of Bordeaux, Bordeaux, France;Neuroradiology Department, Bordeaux University Hospital, CHU Bordeaux, 33000, Bordeaux, France;

关键词: Non-muscle invasive bladder cancer;    Meningeal carcinomatosis;    Complete response;    Chemotherapy;   

DOI  :  10.1186/s12885-017-3309-2

 received in 2016-07-26, accepted in 2017-05-01,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundNon-muscle invasive bladder cancer (NMIBC) is usually treated with local therapy including transurethral resection of the bladder tumor and intravesical therapy depending on the stage of the tumor. NMIBC is a rarely a metastatic diseases with lymph node invasion in less of 10%. In the other hand meningeal carcinomatosis is a rare location for metastases with extremely poor outcomes. We described a case report of a patient presenting a metastatic disease to bones and meninges, several years after the treatment of NMIBC, which had been in complete response (CR) for 4 years after chemotherapy treatment.Case presentationA 63-years old men was treated by TURBT in 2008 for a high grade NMIBC, pT1b. Three years later he presented an acute binocular diplopy with right trochlear nerve paralysis, and labial hypoesthesia. Brain scan and MRI were performed finding a clivus infiltration and a pachymeningitis. A vertebral biopsy was performed finding an invasive carcinoma, CK7+/CK20+, TTF1-, PSA-, Thyroglobulin- and GATA3+. The metastatic event was in relation to the high grade NMIBC treated 3 years previously. Palliative chemotherapy was started with cisplatin gemcitabine. After 6 cycles and to date, 4 years later, the patient is therefore considered in complete response.ConclusionMetastasis in non-muscle invasive urothelial carcinoma is rare. Meningeal carcinomatosis outcome is poor, usually appearing in widely metastatic and progressive cancers but also because most systemic agents fail to pass the blood-brain barrier and penetrate into the cerebrospinal fluid. We described an unexpected response with complete response after chemotherapy for meningeal carcinomatosis of non muscle invasive urothelial carcinoma.

【 授权许可】

CC BY   
© The Author(s). 2017