Primary squamous cell carcinoma of the seminal vesicle

A 69-year-old man with primary squamous cell carcinoma of the seminal vesicle was successfully treated. The patient presented with complaints of gross hematuria and difficulty in urination. Transrectal ultrasonography revealed a cystic mass behind the bladder, and solid tumorous lesions were visualized in the cyst wall by magnetic resonance imaging. The cystic mass was surgically excised and was verified as the enlarged seminal vesicle with concomitant squamous cell carcinoma. The histopathologic diagnosis was squamous cell carcinoma in the seminal vesicle. Postoperatively, 50 Gy of external beam radiation was targeted to the whole pelvic cavity, and the patient was alive without recurrence 2.5 years after surgery. No other neoplasm was discovered in the body.     

Squamous cell carcinoma of bladder

Examination of the histology of all bladder tumors presented to the London Hospital over a ten-year period revealed a surprisingly low incidence of squamous bladder carcinoma. We would support the view of other workers that this tumor usually presents at an advanced stage and carries with it a poor prognosis. However, when no evidence of metastatic disease is evident, treatment with standard protocol of radiation therapy and cystectomy should achieve the same results as for the transitional cell tumor. Squamous cell carcinoma of the bladder would appear to be as radiosensitive as its transitional cell counterpart.     

Metastatic soft tissue squamous cell carcinoma

Metastatic squamous cell carcinoma of the soft tissue is extremely rare. We report two patients with soft tissue metastasis from squamous cell carcinoma of the cervix in one and scalp in another. Case 1: A 63-year-old black woman with a history of cervical cancer presented with a painful mass over the right scapula. An incisional biopsy revealed squamous cell carcinoma. She underwent radiation treatment followed by wide local excision with en bloc resection and a myocutaneous flap closure. Case 2: A 46-year-old white man with a history of squamous cell carcinoma of the scalp and two kidney transplantations requiring long-term immunosuppression presented with a 2-month history of a left proximal arm mass. Magnetic resonance imaging revealed that the mass was within the triceps muscle and fixed to the humerus. Biopsy revealed squamous cell carcinoma. He underwent a shoulder disarticulation for tumor invasion into the adjacent humerus and neurovascular bundles. The patients remain disease-free at 12 and 8 months, respectively. To our knowledge there are no reports of soft tissue squamous cell carcinoma metastatic from the cervix and only rare cases from the lung, head, and neck. The optimal mode of treatment and prognosis is undefined in these patients because of its rare incidence. Surgery and radiation with curative intent were used.     

The perineal implantation of a bladder tumor through urethro-vasal reflux]

Perineal implantation of urinary bladder cancer in a 57-year-old male is reported. The patient had been suffering from incomplete paraplegia and neurogenic bladder for these 29 years because of accidental injury of lumbar spinal cord with episodes of bladder stones two times and right epididymitis three times, and presented urinary leakage from a perineal fistula. The fistula orifice was surrounded by a hard mass lesion. Bilateral swelling of inguinal lymph nodes was present. Fistulogram and voiding cysto-urethrography revealed reflux from posterior urethra to the fistula through right vas and epididymis. Histological diagnosis of resected perineal mass and biopsied left inguinal lymph node was transitional cell carcinoma with predominant metaplasia of squamous cell carcinoma. Tissues obtained by TUR-biopsy of a mass lesion at bladder wall was also histologically diagnosed transitional cell carcinoma with metaplasia of squamous cell carcinoma. The present case indicates implantation of a bladder tumor to perineum by urethero-vasal reflux and metastases to inguinal lymphnodes from the perineal lesion.     

Small cell carcinoma of the urinary bladder with synchronous esophageal cancer and incidental lung cancer: a case report]

We present a case of triple primary cancers occurring synchronously in the urinary bladder, esophagus, and incidentally in the lung. A 65-year-old man with a chief complaint of gross hematuria was admitted to our hospital. Cystoscopy, computed tomography (CT) and magnetic resonance imaging (MRI) revealed a non-papillary broad-based bladder tumor. Histological diagnosis was transitional cell carcinoma of the urinary bladder and he underwent one course of neoadjuvant chemotherapy (M-VAC) with the preoperative diagnosis of T3bN0M0. After one course of chemotherapy, chest CT, lymph node biopsy and esophagoscopy revealed squamous cell carcinoma of the esophagus. He first underwent radiochemotherapy (total 70 Gy, CDDP 5 mg x 41, 5-FU 250 mg x 24) for esophageal cancer and achieved complete remission. Then, he underwent radiotherapy for a total of 60 Gy for bladder cancer. However, his general condition gradually became worse and he died from metastatic cancer. The autopsy proved that he died from multiple metastases of small cell carcinoma of the urinary bladder and incidentally squamous cell carcinoma of the lung was identified.     

Solitary metastasis to the urinary bladder from renal cell carcinoma: a case report

A 48-year-old woman was referred to our hospital with a bladder mass which was detected by a general practitioner. Ultrasonography showed a small bladder tumor and right renal mass. Cystoscopy revealed a solitary, non papillary tumor at the right side of the retro-trigone. Computed tomography revealed a large tumor at the right kidney. Transurethral resection of the bladder tumor was performed. The histopathological diagnosis was clear cell carcinoma. There was no other distant metastasis. Sequentially, radical nephrectomy was performed. Histopathologically, the right renal tumor showed clear cell carcinoma. This was considered to be a case of a solitary metastatic bladder tumor from renal cell carcinoma.     

Squamous cell carcinoma of bladder diverticulum with initial symptoms produced by metastasis to maxillary sinus

A rare case of squamous cell carcinoma in the bladder diverticula of a 74-year-old man with initial clinical symptoms caused by metastasis to the maxillary sinus is reported. The histopathological examination at autopsy confirmed the metastatic squamous cell carcinoma in the maxillary sinus from the bladder diverticula. The vertebral vein plexus seems responsible for this type of metastasis.     

Primary carcinoma in situ of the ureter: a case report]

A 47-year-old man presented with gross hematuria and left lower abdominal dull pain of 6-weeks duration. Cystoscopic examination revealed bloody efflux from the left ureteral orifice but no tumor in the bladder. Retrograde pyelogram showed irregular stricture of middle portion of the left ureter. Cytologic studies of the voided urine and left ureteral urine were positive for cancer, and nephro-ureterectomy with excision of a bladder cuff was carried out. The surgical specimen showed no intraluminal mass but histologically, transitional cell carcinoma in situ with G3 anaplasia and squamous metaplasia was found in the narrowed portion of the ureter. Followup examinations, including exfoliative urinary cytology, cystoscopy and IVP revealed no abnormalities until intravesical recurrence was confirmed 34 months later. Transurethral resection of bladder tumor was performed and superficial papillary transitional cell carcinoma with G2 anaplasia was found in the trigone of the bladder. Followup examinations for the last one year have revealed no abnormalities.     

Inguinal metastasis of a bladder mixed carcinoma with predominant adenocarcinoma component

We report a case of urinary bladder mixed carcinoma with inguinal metastasis. Histological examination of the transurethral resection specimens revealed adenocarcinoma with small foci of squamous and transitional cell carcinomas. A right inguinal metastasis occurred 1 year after radical cystourethrectomy. Chemotherapy and radiotherapy were performed but the metastatic tumor remained unchanged.     

Isolated right ventricular metastasis of uterine cervical carcinoma

Isolated direct metastasis of uterine cervical carcinoma to the right ventricular endocardium is very rare. A 68-year-old woman was initially diagnosed as having stage IIIb squamous cell carcinoma of the uterine cervix, and was treated with radiation therapy. After 2 years, she developed heart failure and presented with a mass in the right ventricle. The results of further examinations were consistent with a tumor or a thrombus in the right ventricle. She underwent excision of the mass under cardiopulmonary bypass, and histopathologic examination of the resected tissue revealed metastatic squamous cell carcinoma of the uterine cervix. She was discharged 3 weeks after the operation, and underwent chemotherapy. However, she was readmitted with drug-induced interstitial pneumonia and died 5 months after the surgery. Patients with an intracardiac mass and a history of uterine cervical cancer should be suspected of having a myocardial metastasis until it is proven otherwise.     

A case of squamous cell carcinoma of the urinary bladder associated with bladder calculi

A case of squamous cell carcinoma of the urinary bladder associated with a bladder stone in a 43-year-old man is reported. Because a 1 cm x 1 cm sized mass was found in the right lateral side of the dome at the time of vesicolithotomy, partial cystectomy was performed. The weight of the stone was 285 g and the tumor was histologically diagnosed as squamous cell carcinoma, grade 2, pT2. Radical cystectomy with ileal conduit was sandwiched by a total of 6 cycles of chemotherapy with PVB. Twelve cases of squamous cell carcinoma of the urinary bladder associated with a bladder stone(s) from the Japanese literature are reviewed, and the relationship between bladder stone, leukoplakia and squamous cell carcinoma discussed.     

Metastatic intrapelvic tumor from esophageal cancer: a case report

We report a case of a metastatic intrapelvic tumor arising from esophageal cancer. The patient, a 74-year-old man, visited our hospital with the chief complaint of gross hematuria. Magnetic resonance imaging and cystoscopy revealed a huge intrapelvic tumor which invaded the bladder, rectum, sigmoid colon and left ilium. The patient underwent total pelvic evisceration with ileal conduit and colostomy. Pathologic diagnosis of the intrapelvic tumor was moderately differentiated squamous cell carcinoma. Preoperatively, gastrointestinal fiberscopy revealed an esophageal tumor, and biopsy showed moderately differentiated squamous cell carcinoma. Finally, the intrapelvic tumor was diagnosed as metastatic tumor from esophageal cancer.     

Carcinoma of the urachus with variable pathological findings: report of a case and review of literature

A 71-year-old man was admitted with the chief complaint of gross hematuria. Cystoscopic examination showed a broadbased papillary tumor at the apex of the bladder. There was edema of the mucous membrane around the tumor. CT-scan demonstrated a mass extending from the bladder dome superiorly. Partial resection of the bladder was done. Pathological examination revealed grade 3 transitional cell carcinoma, with scattered adenocarcinoma and squamous cell carcinoma foci. Chemotherapy with bleomycin (BLM) and cis-dichlorodiamine platinum (CDDP) was done postoperatively. Ten months after the operation, he was readmitted because of recurrence in retroperitoneal lymph nodes. Chemotherapy with BLM and CDDP was done, but he died of pulmonary complications. Autopsy revealed retroperitoneal lymph node metastasis of transitional cell carcinoma. There was no metastasis to any other organ. We briefly discuss 275 cases of the carcinoma of the urachus collected from the Japanese literature.     

Skeletal muscle metastases from urothelial cell carcinoma

Hematogenous metastasis to skeletal muscle from urothelial carcinoma is extremely rare and metastatic disease to skeletal muscle tends to be found in people with advanced-stage neoplasm. We report in this paper a case of left sartorius muscle metastasis from urothelial cell carcinoma. A left nephroureterectomy with bladder cuff excision was performed and revealed a high-grade papillary transitional cell carcinoma (TCC) of the pelvis. And 6 month later, recurrent bladder cancer was found regular cystoscopy and then treated with transurethral resection of the bladder. After 6 times resection of bladder, an invasion into the bladder muscle layer was found. We recommended additional radical cystectomy to prevent the disease from advancing. However, the patient refused additional surgery. 6 month later, the patient complained of left thigh pain, so ultrasonography-guided biopsy of the nodular mass lesion in the left sartorius muscle was performed. The pathological analysis of the biopsy specimen revealed poorly differentiated metastatic urothelial carcinoma.     

A case of carcinosarcoma of the penis

A 64-year-old man presented with gross hematuria. Physical examination showed a mass under the phimotic foreskin. Circumcision revealed a 2cm polypoid tumor on the inner layer of prepuce. Tumor resection was performed and pathological diagnosis was carcinosarcoma which was composed of squamous cell carcinoma and spindle cell sarcoma. Biopsy of the scar lesions revealed residual squamous cell carcinoma and computed tomographic scan revealed swollen inguinal lymph nodes. Partial penectomy and lymph node biopsy were performed. Pathological examination revealed residual squamous cell carcinoma and no lymph node metastasis. There was no recurrence for one year. We report this very rare case of carcinosarcoma of the penis.     

Renal metastasis from squamous cell carcinoma of the hypopharynx

We present a rare case of metastatic renal tumor originating from squamous cell carcinoma of the hypopharynx. A 67-year-old man treated with irradiation for hypopharyngeal carcinoma was referred to our hospital with gross hematuria and a left renal mass, which was delineated as a heterogeneously enhanced mass by CT scan. Left nephrectomy was performed, and the non-encapsulated mass was gray in color macroscopically. Histological examination of the specimen revealed alveolar proliferation of small cancer cells, which was consistent with the original tumor of the hypopharynx. The left renal tumor was diagnosed as poorly differentiated squamous cell carcinoma metastasized from the hypopharynx. The patient remains alive, with no evidence of disease, 8 months following left nephrectomy. This case was thought to be the first report of a renal metastasis from a hypopharyngeal carcinoma that was diagnosed clinically and treated with nephrectomy.     

An effective case of M-VAC therapy of advanced bladder cancer with extramammary Paget's disease

A 66-year-old man complained of gross hematuria, lower abdominal mass and perineal skin erosion. Intravenous pyelography showed a filling defect in the right bladder wall. CT scan demonstrated multiple liver metastasis and lower abdominal mass. Skin biopsy of perineal lesion revealed extramammary Paget's disease. The histopathological study of bladder tumor and lower abdominal mass revealed both to be transitional cell carcinoma grade 3. After four courses of M-VAC therapy described by Sternberg in 1985, bladder tumor and metastatic lower abdominal mass disappeared with CT scan and this effect continued over 6 months. Skin biopsy after chemotherapy revealed a marked reduction in Paget's cell number.     

Renal Failure,Paraproteinemia, and Lung Squamous Cell Carcinoma

A 66-year-old man presented with gastrointestinal symptoms and acute renal failure. He had paraproteinemia and tested positive for antinuclear antibodies. There was no evidence for autoimmune disorder or amyloidosis, and bone marrow biopsy was not consistent with multiple myeloma. Three months later he presented with diffuse lymphadenopathy and right lung mass, and lymph node histology revealed metastatic squamous cell carcinoma. This association of paraproteinemia and nonlymphatic neoplasia is unusual and still very rare. A review of the literature is presented.     

Metastatic renal cell carcinoma to the bladder 12 years after radical nephrectomy

We report, herein, a case of metastatic renal cell carcinoma of the urinary bladder. A 76-year-old man presented to our hospital. He had undergone right radical nephrectomy at 64 years of age. Cystoscopy revealed a solitary, spherical tumor 1.5 cm in size protruding into the urinary bladder. Transurethral resection was performed and the pathological diagnosis of the lesion was clear cell carcinoma. The patient is alive 12 months after recurrence to the bladder, under the administration of interleukin-2.     

Squamous cell carcinoma in a Müllerian duct cyst: Report of a case

A 36-year-old man presented with a pelvic mass which proved to be a Müllerian duct cyst. The cyst was determined to be squamous cell carcinoma which involved the rectum and the bladder. A total pelvic exenteration was carried out for complete resection.