Low Grade Lymphoma Mimicking Metastatic Urothelial Carcinoma: When Do We Need Further Histologic Staging?

Abstract

Introduction. Patients with urothelial carcinoma of the bladder often present with metastases to regional lymph nodes, with lymphadenopathy on physical examination or radiographic imaging. Case Presentation. We present the case of a 73-year-old Caucasian man with presumed metastatic urothelial carcinoma of the bladder to regional pelvic and retroperitoneal lymph nodes. He underwent systemic chemotherapy for treatment of urothelial carcinoma and was discovered on restaging to have findings suggestive of disease progression but ultimately was found to have a concurrent secondary malignancy. Conclusion. Our case suggests that in patients with urothelial carcinoma, the concurrent presentation of regional lymphadenopathy may not be metastatic urothelial carcinoma and may warrant further investigation.

Analysis of Overall Survival in Patients With Multiple Primary Malignancies: A Single-center Experience

“…Patients diagnosed with a malignancy (i.e., first malignancy) have frequent follow up in the oncology clinic and hence get frequent imaging for both initial staging as well as to analyze the response of treatment to their malignancy. Frequent imaging and follow-up make it more likely to diagnose a second malignancy, and hence makes it more likely to invasively pursue biopsies of atypical lesions, that may be simply watched in surveillance in a non-oncology clinic setting [13]. Early diagnosis of a second malignancy and prompt treatment likely play a role in improved OS in the simultaneous group.…”