Meningeal Carcinomatosis: An Extremely Rare Involvement of Urinary Bladder Carcinoma

Uncu, Doğan; Arpacı, Fikret; Beyzadeoğlu, Murat; Günal, Armağan; Surenkok, Serdar; Öztürk, Mustafa; Özet, Ahmet

doi:10.1177/030089161009600229

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…Still, just as many cases present concurrently with widespread systemic disease, suggesting that TCC may have an affinity for the CNS and that carcinomatous meningitis may be more common than realized. The prognosis for most patients with carcinomatous meningitis secondary to TCC is dismal, with patients surviving a median of 38 days [31]. Our review confirms the poor prognosis with an average survival of 2.2 months for all patients in which survival has been reported.…”

Section: Discussionsupporting

confidence: 71%

Carcinomatous Meningitis: The Natural History of Successfully Treated Metastatic Bladder Cancer

Tadepalli

Coleman²,

Hacket³

et al. 2011

Case Rep Oncol

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Carcinomatous meningitis due to bladder cancer is a rare entity reported only in case reports. Optimal therapy is thus poorly defined with earlier cases reporting an unsuccessful outcome. Here we report a case of late carcinomatous meningitis secondary to transitional cell carcinoma (TCC) of the bladder occurring in a patient in complete remission. He was successfully treated with intrathecal methotrexate and whole brain irradiation and experienced prolonged survival after treatment. With modern chemotherapy increasing complete remissions and survival rates in patients with TCC, more and more patients are being reported with carcinomatous meningitis. We raise the question of whether central nervous system prophylaxis should be considered in patients with TCC achieving a complete remission to chemotherapy in the metastatic setting.

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Section: Discussionsupporting

confidence: 71%

Carcinomatous Meningitis: The Natural History of Successfully Treated Metastatic Bladder Cancer

Tadepalli

Coleman²,

Hacket³

et al. 2011

Case Rep Oncol

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“…Overall survival (OS) decreases from 18 months in inoperable locally advanced bladder cancers, to 8.5 months in the case of visceral metastases, and even to 38 days in the case of MC [9, 10]. …”

Section: Discussionmentioning

confidence: 99%

Metastatic non-muscle invasive bladder cancer with meningeal carcinomatosis: case report of an unexpected response

et al. 2017

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BackgroundNon-muscle invasive bladder cancer (NMIBC) is usually treated with local therapy including transurethral resection of the bladder tumor and intravesical therapy depending on the stage of the tumor. NMIBC is a rarely a metastatic diseases with lymph node invasion in less of 10%. In the other hand meningeal carcinomatosis is a rare location for metastases with extremely poor outcomes. We described a case report of a patient presenting a metastatic disease to bones and meninges, several years after the treatment of NMIBC, which had been in complete response (CR) for 4 years after chemotherapy treatment.Case presentationA 63-years old men was treated by TURBT in 2008 for a high grade NMIBC, pT1b. Three years later he presented an acute binocular diplopy with right trochlear nerve paralysis, and labial hypoesthesia. Brain scan and MRI were performed finding a clivus infiltration and a pachymeningitis. A vertebral biopsy was performed finding an invasive carcinoma, CK7+/CK20+, TTF1-, PSA-, Thyroglobulin- and GATA3+. The metastatic event was in relation to the high grade NMIBC treated 3 years previously. Palliative chemotherapy was started with cisplatin gemcitabine. After 6 cycles and to date, 4 years later, the patient is therefore considered in complete response.ConclusionMetastasis in non-muscle invasive urothelial carcinoma is rare. Meningeal carcinomatosis outcome is poor, usually appearing in widely metastatic and progressive cancers but also because most systemic agents fail to pass the blood-brain barrier and penetrate into the cerebrospinal fluid. We described an unexpected response with complete response after chemotherapy for meningeal carcinomatosis of non muscle invasive urothelial carcinoma.

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“…[2][3][4][5] Noninvasive imaging plays a pivotal role in the staging and restaging of bladder cancer. Usually, the development of brain and leptomeningeal metastases is a late event in the course of bladder carcinoma, occurs most often in patients with extensive systemic disease and have a bad prognosis despite aggressive therapy.…”

Section: Discussionmentioning

confidence: 99%

“…1 Brain metastases are relatively infrequent, but are often seen during chemotherapy in the advanced stage of bladder carcinoma, reported incidences 1-8%. 4,5 The staging of UCB is an essential step in appropriate management of disease. Leptomeningeal metastases occur in 1-8% of all cancer patients and inevitably have a fatal outcome.…”

Section: Introductionmentioning

confidence: 99%

A case of brain and leptomeningeal metastases from urothelial carcinoma of the bladder

Erhamamcı¹,

Reyhan²,

Altinkaya³

2014

Revista Española de Medicina Nuclear e Imagen Molecular (Englis

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Keywords:Urothelial bladder carcinoma Brain metastases Leptomeningeal metastases FDG PET/CT a b s t r a c t Brain metastases are unusual from urethelial carcinoma of bladder and particularly the occurrence of leptomeningeal metastases is extremely rare, with few cases described in the literature. We present a case of a 45-year-old man with a rare brain metastases as the first metastatic manifestation secondary to urethelial carcinoma of bladder followed by leptomeningeal metastases without any other organ involvement. Eleven months after the diagnosis of high-grade urethelial carcinoma of bladder (T2N0M0), the patient was detected having brain metastases by MRI. FDG PET/CT images for the metastatic evaluation showed no abnormal FDG uptake elsewhere in the body except the brain. Histopathology examination from brain lesion demonstrated the cerebral lesion to be a metastatic urothelial carcinoma. Two months later, the patient was diagnosed to have leptomeningeal metastases by MRI. Our patient's condition gradually worsened, and he died 3 months after the diagnosis of leptomeningeal metastases. Un caso de metástasis cerebrales y leptomeníngeas de un carcinoma urotelial de vejigaPalabras clave: Carcinoma urotelial de vejiga Metástasis cerebral Metástasis leptomeníngea FDG PET/TC r e s u m e n Las metástasis cerebrales del carcinoma urotelial de vejiga son poco habituales y, en particular, las metástasis leptomeníngeas son extremadamente raras, siendo pocos los casos descritos en la literatura. Presentamos un hombre de 45 años con metástasis cerebral como primera manifestación secundaria de un carcinoma urotelial de vejiga seguido de metástasis leptomeníngeas sin otra afectación sistémica. Once meses después del diagnóstico de un carcinoma urotelial de vejiga (T2N0M0), se detectaron metástasis cerebrales por RM. El estudio de estadificación con FDG PET/TC no demostró captación anormal en otra parte del cuerpo a excepción del cerebro. El examen histopatológico de una lesión cerebral demostró metástasis del carcinoma urotelial. Dos meses después, una RM descubrió metástasis leptomeníngeas. La situación clínica del paciente se deterioró gradualmente, y falleció 3 meses después del diagnóstico de las metástasis leptomeníngeas.

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Meningeal Carcinomatosis: An Extremely Rare Involvement of Urinary Bladder Carcinoma

Cited by 10 publications

References 16 publications

Carcinomatous Meningitis: The Natural History of Successfully Treated Metastatic Bladder Cancer

Carcinomatous Meningitis: The Natural History of Successfully Treated Metastatic Bladder Cancer

Metastatic non-muscle invasive bladder cancer with meningeal carcinomatosis: case report of an unexpected response

A case of brain and leptomeningeal metastases from urothelial carcinoma of the bladder

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