Responsiveness of Skin Metastases to CMF in A Patient with Urothelial Carcinoma of the Bladder: A Case Report

Abstract

Skin metastases from urothelial carcinoma of the bladder are uncommon, and there are few cases reported in literature. The present case report describes the results of a combination of cyclophosphamide, methotrexate and 5-fluorouracil (CMF) administered as second-line chemotherapy in a cisplatin-resistant metastatic bladder cancer patient. The improvement in cutaneous lesions and pain reduction obtained prompt further exploration of the activity of this regimen in a second-line approach.

Cutaneous metastases from internal malignancies

“…No specific chemotherapeutic drug is favored in the systemic treatment of cutaneous metastases. Observations of regressive cutaneous metastases conditional on systemic chemotherapy are limited and include cutaneous metastases of pancreatic cancers treated with gemcitabine (55) or of urothelial carcinoma of the bladder treated with cyclophosphamide, methotrexate, and 5‐fluorouracil (74). Substances for the treatment of single cases in cohorts with CUP were cisplatin, gemcitabine, vinorelbine, and paclitaxel (154,155).…”

“…Further case reports are suggestive of a meaningful distribution of metastases on face and scalp (12,67,68). Cutaneous metastases of kidneys and bladder tend to be more serious like lobulated masses, fragile, ulcerated or bleeding and involvement of deeper skin layers (69–74). Extremely exceptional cutaneous metastases from renal origin are a necrotic tumor nodule which destroyed the end phalanx of a toe and a fungating lesion involving the corona and glans penis (73,75).…”