Extensive cutaneous metastasis of transitional cell carcinoma of the bladder

Cutaneous metastasis of bladder carcinoma is extremely rare. Iatrogenic implantations have been the main cause in the majority of cases of transitional cell carcinoma with cutaneous metastasis. Otherwise, primary cutaneous metastasis is accepted as the late manifestation of systemic spread. The present paper describes a case of relatively early and extensive skin metastasis of transitional cell carcinoma in a 78-year-old man. The patient had a histopathological diagnosis of poorly differentiated (grade III) muscle invasive transitional cell carcinoma with a staging of T2NOMO 6 months prior to presenting. He presented to our outpatient clinic with a 3-month history of skin lesions as multiple, rubbery subcutaneous nodules. Radiological reinvestigation revealed no other metastatic site (including bone and lung), except for a metastatic nodule in the liver. The present paper reports an interesting and rare case of extensive skin metastasis of transitional cell carcinoma as the primary complaint.     

Orbital metastasis,by transitional cell carcinoma of the bladder

We report a new case of a patient with transitional cell carcinoma of the urinary bladder and a solitary metastasis to the orbita. A review of the literature shows two cases described previously. This case is interesting for the clinical features and evolution.     

Synchronous solitary metastasis of transitional cell carcinoma of the bladder to the testis

We report a late recurrence of a cholesteatoma of the left kidney after 15 years. Both the initial case and the recurrence were treated by endourologic and percutaneous approaches.     

Penile metastasis arising from transitional cell carcinoma of the urinary bladder

Metastatic spread of transitional cell carcinoma of the bladder to the penis is very rare. We present 1 such case in a 63-year-old man that was treated by total penectomy and adjuvant systemic chemotherapy.     

Solitary cerebellar metastasis from transitional cell carcinoma of bladder.

Brain metastasis from transitional cell carcinoma of the bladder is unusual, occurring most often in the presence of widespread systemic metastases. We report on a patient who presented with an isolated cerebellar metastasis and recurrent carcinoma of the bladder, after treatment with local excision and intravesical thiotepa. Further evaluation failed to demonstrate other distant metastases. Excision of the cerebellar lesion revealed transitional cell carcinoma identical to the original bladder tumor. In a review of the literature, we found reports of two similar patients in whom a solitary cerebellar lesion was the first sign of metastasis from carcinoma of the bladder; neither patient had evidence of other distant metastases, and neither previously had received systemic chemotherapy. These observations indicate that central nervous system metastasis from carcinoma of the bladder, while rare, should be considered in the differential diagnosis of solitary intracerebellar lesions in such patients.     

阴茎转移性膀胱移行细胞癌一例报告并文献复习

目的 提高对阴茎转移性膀胱移行细胞癌的认识。方法 报告1例阴茎转移膀胱移行细胞癌患者资料,结合文献讨论其发病机理、临床特征及诊疗措施。患者,男,60岁,膀胱顶壁肿瘤行膀胱部分切除术后11个月余,病理报告为膀胱移行上皮细胞癌Ⅲ级,侵及深肌层,分期G3T3,发现阴茎海绵体硬结逐渐增大6个月余入院。结果 阴茎海绵体硬结细针穿刺活检示纤维组织中散在异型细胞及异型细胞巢,考虑为低分化癌,行阴茎全切术。术后病理报告示海绵体间质纤维中有成团的癌组织,符合膀胱移行细胞癌转移至阴茎,切缘未见癌组织,另送检耻骨前淋巴组织未见肿瘤细胞浸润。术后12d拔除导尿管。术后4周耻骨上区和双侧腹股沟区予^60Coγ射线3000cGy放射治疗,定期丝裂霉素膀胱灌注治疗和膀胱镜检查。现患者蹲式小便、排尿正常,随访16个月肿瘤无复发和转移。结论 阴茎海绵体硬结细针穿刺活检是诊断阴茎转移癌安全、有效的方法。盆腔内存在丰富、低压力、无静脉瓣的静脉丛及淋巴循环,当回流通路阻塞或压力升高时会发生逆流导致肿瘤细胞扩散或微转移,可能是阴茎转移性膀胱癌的发病机理。术后综合治疗措施可以预防肿瘤复发、提高治疗效果：     

Testicular metastasis of transitional cell carcinoma of the urinary bladder: An unusual site

We present a 74-year-old man with a testicular metastasis originating from a transitional cell carcinoma of the urinary bladder. Initially, radical cystectomy and ileal-conduit urinary diversion were performed. Three years later, he presented with a tumor in the left testicle, proved to harbor transitional cell carcinoma.     

Clinical study of transitional cell carcinoma of the prostate associated with bladder transitional cell carcinoma

BACKGROUND: Transitional cell carcinoma of the prostate in patients with bladder cancer appears to influence the prognosis and affects the decision about therapeutic modality. Therefore, it is important to characterize transitional cell carcinoma associated with bladder cancer. METHODS: From April 1980 to December 1998, 81 male patients underwent total cystoprostatectomies for transitional cell carcinoma of the bladder. The 81 cystoprostatectomy specimens were examined to clarify the characteristics of prostatic involvement by transitional cell carcinoma. The extent, origin, mode of spread and risk factor of prostatic involvement as well as the prognosis were investigated. In 13 of 15 patients with prostatic involvement the prostate was examined by sequential step sections. RESULTS: Prostatic involvement was observed in 15 of 81 patients (18.5%). Prostatic urethral involvement, invasion to prostatic duct/acinus, prostatic stromal invasion and extraprostatic extension and/or seminal vesicle involvement were recognized in 12 (80%), 14 (93.3%), six (40%), and five (33.3%) of the 15 patients, respectively. Twelve of the 15 patients (80%) with prostatic involvement had papillary or non-papillary tumors (i.e. carcinoma in situ) both in the prostatic urethra and prostatic duct. In 10 of these 12 patients (88.3%), there was contiguity between prostatic urethral and ductal tumors. Seven of the 23 patients (30.4%) with carcinoma in situ of the bladder showed prostatic involvement, which increased to 50% in the presence of carcinoma in situ of the trigone or bladder neck. CONCLUSIONS: Eighty per cent of the patients with prostatic involvement showed papillary or non-papillary tumors both in the prostatic urethra and prostatic duct. There was a high level of contiguity between both tumors. Patients with carcinoma in situ of the trigone or bladder neck revealed significantly higher incidence of prostatic involvement.     

Plasmacytoid transitional cell carcinoma of the urinary bladder

A case of rare plasmacytoid transitional cell carcinoma of the urinary bladder in a 60-year old man is described. The presence of end-stage disease did not allow for any efficacious therapy. Immunohistochemistry showed the tumor cells to be reactive for epithelial markers and syndecan-1 (CD138).     

Ossified metastatic transitional cell carcinoma of the bladder

A case of ossified tumor in the anterior abdominal wall that proved to be a metastatic transitional cell carcinoma of the bladder is reported. Computerized tomography detected dense calcification within the tumor but it did not differentiate ossification from calcification. A soft x-ray roentgenogram of the resected tumor revealed a fine trabecular pattern of the ossified area.     

基质金属蛋白酶血清含量与膀胱移行细胞癌浸润转移的关系

目的探讨基质金属蛋白酶-2（MMP-2）和基质金属蛋白酶-9（MMP-9）的血清含量与膀胱移行细胞癌侵袭转移的关系。方法采用酶联免疫吸附试验（ELISA）对46例膀胱移行细胞癌患者血清中的MMP-2及MMP-9进行测定,并与18例正常血清进行对照分析。结果膀胱移行细胞癌患者同正常对照组比较,血清中MMP-2和MMP-9含量均显著增高（P〈0.000）,血清中MMP-2和MMP-9含量随着临床分期的升高均有显著性增高（P〈0.0000）,膀胱癌组织学Ⅱ、Ⅲ级患者血清中MMP-2和MMP-9含量明显高于I级（P〈0.0000）,但两者间比较无显著性差异（P〉0.05）。站论MMPs与膀胱移行细胞癌的发生、发展及侵袭转移密切相关,MMPs血清学测定可作为判断膀胱肿瘤预后的指标之一。     

膀胱移行细胞癌微血管分型及意义

为探讨膀胱移行细胞癌组织中肿瘤微血管不同类型与浸润和转移的关系，应用免疫组织化学ＳＰ法在６１例膀胱移行细胞癌组织中对第Ⅷ因子相关抗原进行表达并计数，根据肿瘤组织中微血管（ＭＶ）的分布特点及其与肿瘤组织的关系，将ＭＶ分为两型：Ⅰ型为肿瘤组织内ＭＶ，位于癌组织内，血管迂曲，扩张，变形；Ⅱ型为肿瘤旁ＭＶ，位于肿瘤边缘，血管分布不均。结果显示浸润性癌组的Ⅱ型ＭＶ数显著高于Ⅰ型ＭＶ数（Ｐ＜００５），在浅表性癌组中Ⅰ，Ⅱ型ＭＶ数之间无显著性差异（Ｐ＞００５），伴淋巴结转移的癌组织Ⅱ型ＭＶ数显著高于Ⅰ型ＭＶ数（Ｐ＜００５）。认为肿瘤血管的生长有很大的异质性，肿瘤边缘的微血管与肿瘤的浸润有密切关系。     

Micropapillary variant of transitional cell carcinoma of the bladder

A 77-year-old man visited the Kobe City General Hospital complaining of macroscopic hematuria. A computed tomography scan found a bladder tumor with left iliac and para-aortic lymph node metastasis. Two courses of cisplatin, cyclophosphamide and doxorubicin chemotherapy resulted in a minimal response. Radical cystectomy and a retroperitoneal lymph node dissection with bilateral ureterocutaneostomy reconstruction were then performed. A pathological examination revealed a micropapillary variant of transitional cell carcinoma (Grade 3, pT1pN2M1). The patient died of pelvic recurrence 7 months after the initiation of chemotherapy. Peritonitis carcinomatosa and lung metastases were observed at autopsy.     

表浅性膀胱肿瘤的预后

从１９８０年１月至１９９１年１２月，对１２１例表浅性膀胱肿瘤进行回顾性研究，首次手术采用经尿道肿瘤电灼术，电切术或膀胱部分切除术，术后配合膀胱内灌药辅助治疗。其中６０例术后复发（４９．６％），术后１、２、３和５年的无瘤率分别为８６．８％、７６．８％、７３．５％和６８．６％。资料表明，初诊时呈多发者、直径大于１ｃｍ和细胞恶性分级高的肿瘤术后无瘤率分别低于单发者、直径小于１ｃｍ和细胞恶性分级低的肿瘤，有显著性差异（Ｐ＜０．０５）。术后６个月内肿瘤复发者经治疗后肿瘤再次复发的机会高。术后膀胱内灌药可以预防肿瘤复发，以灌注丝裂霉素和卡介苗效果好。