Central Nervous System Metastasis in Patients With Urothelial Carcinoma: Institutional Experience and a Comprehensive Review of the Literature

Diamantopoulos, Leonidas; Khaki, Ali Raza; Sonpavde, Guru; Venur, Vyshak Alva; Yu, Evan Y.; Wright, Jonathan L.; Grivas, Petros

doi:10.1016/j.clgc.2019.11.008

Cited by 15 publications

(30 citation statements)

References 69 publications

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“…The first case of urothelial carcinoma metastasizing to the brain was reported by Lower and Watkins in 1924 [5,6,9]. Since then, reports of similar cases published in the literature have been few and far between.…”

Section: Discussionmentioning

confidence: 99%

“…Urothelial carcinoma (UC), also known as transitional cell carcinoma (TCC), accounts for more than 90% of all bladder cancers in the western world and is the fifth most common malignancy worldwide, comprising 2% of all reported malignancies [1][2][3][4][5]. Ninety percent of urothelial carcinomas present as bladder tumors, with approximately 5-10% presenting as upper tract urothelial carcinomas (UTUC) that involve the renal pelvis, ureters, or calyces, although UC can arise anywhere along the urinary tract [2,6,7].…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, 1-7% of patients are reported to have brain metastases from primary UC, although reliable data on this prevalence is scarce and estimates vary in part due to the rarity of reported cases [1,4,5]. Thus, routine neurological imaging for intracranial metastases is often not recommended [6].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The occurrence of brain metastases confers a poor prognosis, with some authors estimating the median survival of treated patients to be 2-4 months while the median survival of untreated patients ranges from a couple days to 1.75 months [5,6]. Additionally, the estimated median time to brain metastasis in patients with UC was 10 months [6]. The rare occurrence and poor prognosis of brain metastases in UC contribute to the uncertain management and treatment protocol for these patients, which we hope to help elucidate through the contribution of this report.…”

Section: Introductionmentioning

confidence: 99%

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Urothelial Carcinoma of the Bladder With Primary Metastasis to the Brain: A Case Report and Literature Review

Sankhyan¹,

Anderson²,

Urquiaga³

et al. 2022

Cureus

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Brain metastases are the most common type of brain tumor in adults, commonly arising from primary tumor sites of the lung, breast, skin (melanoma), colon, and kidney. Isolated central nervous system (CNS) metastasis arising from urothelial carcinoma (UC) is a rare presentation yielding a poor prognosis.A 71-year-old male patient with a history of urothelial carcinoma, treated one year prior with partial cystectomy and adjuvant gemcitabine and cisplatin (GC) therapy, presented with worsening neurological symptoms, including progressively worsening dizziness, shuffling gait, drifting, expressive aphasia, and confusion. MRI revealed a left frontal 4.0 x 3.6 cm brightly contrast-enhancing tumor with possible hemorrhage, extensive vasogenic edema, and moderate mass effect. An additional smaller right cerebellar lesion was also noted. Outpatient CT of his chest, abdomen, and pelvis revealed no evidence of other malignant sites. He ultimately underwent a left craniotomy with a total resection of his left frontal mass. Pathological examination revealed a urothelial primary. Post-operative MRI revealed complete resection of the left frontal mass and the patient was discharged with no neurologic deficits on exam.In many cases, brain metastases may present years later following initial therapy of UC as the CNS may act as a sanctuary site during systemic chemotherapy. Chemotherapeutics such as gemcitabine with better penetration of the blood-brain barrier may be beneficial in delaying the onset of these metastases.

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Section: Discussionmentioning

confidence: 99%