Non–Muscle Invasive Papillary Urothelial Carcinoma Metastatic to the Mandible

Abstract

Urothelial carcinoma, the most common histologic subtype of bladder cancer in the United States, most frequently presents as non–muscle invasive disease. Initially, therapy involves transurethral endoscopic resection and subsequent intravesical therapies with extended surveillance for high-risk disease. Even with the best treatments, recurrence and progression can occur. However, metastasis of non–muscle invasive bladder cancer to distant sites without evidence of progression or regional metastasis is rare. In this article, we present the case of a patient with high-grade papillary urothelial carcinoma who developed an unusual metastasis to the mandible, confirmed by GATA-3 immunostaining, over 4 years after initial transurethral resection. Prior to the development of metastatic disease, this patient had no evidence of local recurrence during maintenance Bacillus Calmette-Guerin intravesical therapy and concurrent surveillance. Positron emission tomography-computed tomography taken after presentation with mandibular metastasis did not show any evidence of regional metastasis. This case highlights an unusual location for distant metastasis of urothelial carcinoma occurring in a patient without evidence of muscle invasive disease or regional metastasis. We additionally highlight the utility of GATA-3 immunostaining in identifying urothelial carcinoma histologically.

Urothelial carcinoma with mandibular metastasis and synchronous prostate cancer

“…BC metastatic to the jaw is rare, with 14 prior reported cases 4 5. Our patient was found to have non-muscle invasive urothelial cancer that metastasised to the mandible as well as high-risk PC.…”

“…The most common reported sites of metastases are lymph nodes, bones, lung, liver and peritoneum 3. Mandibular metastasis is rare with 14 prior reported cases to our knowledge 4 5. We present a case of non-muscle invasive urothelial cancer metastasised to the mandible and synchronous high-risk prostate cancer (PC).…”