Background:
Urothelial carcinoma is the most common malignancy of the bladder and is primarily considered as a disease of the elderly. Studies that address bladder tumor occurrence in young age groups are rare.
Case Presentation:
A 19-year-old male presented with a gross total painless hematuria. A histology after biopsy revealed a high-grade transitional cell carcinoma with lymph node metastasis. The patient succumbed to the disease on day 72 of the treatment. Here, we used whole-exome sequencing of a paired tumor-normal sample to identify the somatic mutations and the possible targets of treatment.
Result:
We predicted eight potential driver mutations (
TP53
p.V157L,
RB1
c.1498+1G>T,
MED23
p.L1127P,
CTNND1
p.S713C,
NSD1
p.P2212A,
MED17
p.G556V,
DPYD
p.Q814K, and
SPEN
p.S1078
*
). In addition, we predicted deleterious mutations in genes involved in the ion channels (
CACNA1S
p.E1581K,
CACNG1
p.P71T,
CACNG8
p.G404W,
GRIN2B
p.A1096T,
KCNC1
p.G16V,
KCNH4
p.E874K,
KCNK9
p.R131S,
P2RX7
p.A296D, and
SCN8A
p.R558H).
Conclusions:
Most likely, mutations in genes involved in ion channels may be responsible for the aggressive behavior of a tumor. Ion channels are the second largest class of drug targets, and may thus serve as a putative potential therapeutic target in advanced stage urothelial carcinoma.