Femoral metastasis in previously treated bladder cancer patient: A case report

Al-Hejazi, Tala Jouma; Bdeiwi, Hassan; Sukkari, Mohamad Walid; Ibrahim, Mohamad Nasir Mohamad; Sukari, Ammar; Alloush, Hani

doi:10.1002/ccr3.6357

Cited by 1 publication

(1 citation statement)

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“…Bisphosphonates, zoledronic acid, and denosumab can also be used in metastatic spine disease to reduce the incidence of skeletal-related events like fractures and cord compressions, although it is not a primary method of treatment [11]. Surgery is generally palliative and aims to relieve the pain and restore some function [12]. The efficacy of these management modalities depends upon histological tumor type, tumor stage, and tumor spread.…”

Section: Discussionmentioning

confidence: 99%

Urothelial Carcinoma With Bone Metastasis Mimicking Sciatica: A Common Neoplasm With an Uncommon Presentation

Kaur,

Iqbal

et al. 2024

Cureus

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Bone metastasis in urothelial cancer is underreported and not well-researched. A case of urothelial carcinoma (UC) with bone metastasis presenting as musculoskeletal pain is reported. The patient presented with persistent lower back pain associated with right lower extremity pain, numbness, and tingling. Initially, a diagnosis of sciatica was suspected, but the patient did not respond to treatment. An MRI spine was done, which revealed a bright signal mass in the vertebral body suspicious for a metastatic lesion, left hydroureteronephrosis, and a nonspecific cystic focus in the right iliacus muscle. Subsequent imaging revealed an irregular soft tissue mass at the left posterolateral bladder base, resulting in apparent obstruction of the left ureter, highly suggestive of neoplasm, along with numerous lytic bone lesions in the pelvic girdle with associated soft tissue masses, consistent with metastatic disease. The patient underwent an interventional radiology biopsy of the right iliac soft tissue mass to evaluate the lytic bony lesions, which revealed metastatic carcinoma, consistent with UC. A prompt referral was made for urology and oncology consultations. The patient underwent left percutaneous nephrostomy placement for obstruction, but he was not a candidate for any systemic therapy because of his poor performance status, and hospice was recommended as his metastatic disease was not curable and the goal of any kind of treatment was palliative. The optimal treatment for UC with bone metastasis remains divergent, and the management options should be determined as part of a shared decision-making process. This case highlights the importance of having a high suspicion of neoplastic pathology in patients presenting with musculoskeletal pain, like back pain, and not responding to treatment. This should alert the physicians to the potential for serious disease processes.

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Section: Discussionmentioning

confidence: 99%