Late urinary bladder metastasis from breast cancer

Abstract

Introduction: Breast cancer (BrC) is the most common non-dermatologic cancer in women. It frequently metastasizes to lung, liver and bone, while the urinary bladder is considered as an unusual site for BrC metastases. Materials and methods: Four years after her first oncologic surgical approach, a known BrC patient complained of a left flank pain, dysuria and urgency. Computed tomography (CT scan) imaging showed an irregular thickening of the left bladder wall and bilateral hydronephrosis. Results: A bladder metastases from BrC was diagnosed based on a histological examination of a transurethral resection of the bladder (TURB-T) specimen. Conclusions: In patients with a history of BrC, urinary bladder screening is not needful. However, if low urinary symptoms persist, an evaluation of the bladder should be considered to rule out metastatic involvement.

An unusual location for metastasis – Breast cancer in the bladder

“…Our patient presented with frequency, urgency, incontinence, gross hematuria, flank pain and a rising creatinine; symptoms in line with those of other case reports. 2 , 3 , 4 , 5 Creatinine changes are associated with obstruction rather than indicative of the presence of metastases. 3 These presenting symptoms are non-specific within the field of urology.…”

“…CT is the most used imaging method leading to initial suspicion of bladder malignancy. Characteristic findings include bladder wall thickening, 2 , 4 , 5 enhancing lesions, 3 hydronephrosis 4 and presence of spine metastases 5 in a patient with LUTS. Cystoscopy typically notes inflammatory changes, 4 wall thickening, 3 granulation tissue 5 and a general suspicion that visualized tissue is abnormal and not classical for bladder cancer.…”

“…Characteristic findings include bladder wall thickening, 2 , 4 , 5 enhancing lesions, 3 hydronephrosis 4 and presence of spine metastases 5 in a patient with LUTS. Cystoscopy typically notes inflammatory changes, 4 wall thickening, 3 granulation tissue 5 and a general suspicion that visualized tissue is abnormal and not classical for bladder cancer. 4 Breast cancer metastases to the bladder typically occur ≥5 years after primary breast cancer diagnosis and are reported as late as 17 years later.…”

“…Other case reports of breast cancer metastases to the bladder consider incidence, treatment, and congruity of primary and metastatic immunohistochemistry. 2 , 3 , 4 Our case is one of incongruent primary and metastatic immunohistochemistry and our discussion focuses on detection and consideration from the field of urology, rather than oncological management.…”

Hydronephrosis Caused by Metastatic Breast Cancer

“…A PubMed search for the keywords "breast cancer" and "hydronephrosis" identified 10 cases of postoperative recurrence, as shown in Table 2 [3][4][5][6][7][8][9][10][11][12]. The median time from surgery to diagnosis of hydronephrosis was 76.5 months (18-360 months), and the histological type was IDC in 4 cases, ILC in 5 cases, and unknown in 1 case.…”