Intracranial metastasis from primary transitional cell carcinoma of female urethra: case report & review of the literature

Abstract

BackgroundTransitional cell carcinoma (TCC) of the female urethra is a rare urological malignancy, and intracranial metastasis of this cancer has not yet been reported in the literature. This review is intended to present a case of multiple intracranial metastasis in a female patient with a remote history of primary urethral TCC.Case PresentationA 49-year-old woman, presented with a prolapsed mass in urethral orifice that was diagnosed as primary urethral TCC with distant lung and multiple bone metastases. The patient subsequently underwent chemotherapy under various regimens. A year later, the patient developed headache and vomiting which as was found to be due to multiple intracranial metastasis. The patient underwent surgical resection of the largest lesion located on the cerebellum, and consecutively gamma knife radiosurgery was performed for other small-sized lesions. Pathological examination of the resected mass revealed a metastatic carcinoma from a known urethral TCC. Serial work-up of systemic metastasis revealed concomitant aggravation of lung, spleen, and liver metastasis. The patient died of lung complication 2 months after the diagnosis of brain metastasis.ConclusionTo the best of our knowledge, this is the first reported case of cerebral metastasis from primary urethral TCC, with pathological confirmation. As shown in intracranial metastasis of other urinary tract carcinoma, this case occurred in the setting of uncontrolled systemic disease and led to dismal prognosis in spite of aggressive interventional modalities.

Recurrent oligometastatic transitional cell bladder carcinoma: is there room for radiotherapy?

“…Single case reports and series of SBRT for primary TCC and renal cell carcinoma of kidney show very promising results [19][20], but there are no consistent data in literature about the oligometastatic/oligorecurrent setting of TCC. We retrospectively evaluated our small series of patients in order to investigate the possible role of irradiation using high precision technologies in the treatment of oligometastatic/ oligorecurrent bladder cancer patients.…”

“…Stereotactic body radiotherapy (SBRT) has been studied in numerous settings including oligometastatic lung, colorectal, prostate and breast cancer [11][12][13][14][15][16][17]. Only limited data are available for SBRT in oligometastatic bladder cancer, including mainly case reports and series of SBRT for primary transitional cell carcinoma (TCC) and renal cell carcinoma of kidney [18][19][20][21].…”

Metastatic brain tumor from urothelial carcinoma of the prostatic urethra

“…Cases of metastatic urothelial carcinoma usually show poor outcomes,[ 6 11 ] because when it does occur, it has already been in the setting of a widespread metastatic disease. [ 4 ] However, in this case, the CT images showed no other apparent metastasis.…”

Traumatic Urethral Diverticula: A Rare Malformation of the Male Urethra

“…Malignant degeneration with the development of a malignant tumor in the diverticulum is a rare complication that must be taken into account. The reason for malignant transitional cell transformation is unknown, and diverticula are considered to more often favor the malignant transformation of clear cells within urethral glands, few presented with high-grade transitional cell carcinoma in situ within a urethral diverticulum [3,4]. The clinical presentation commonly includes hematuria, urinary tract infection and irritative or obstructive voiding symptoms, ventral bulging and displacement of the penile shaft.…”