Squamous cell carcinoma of the bladder presenting as vulvitis and cliteromegaly

Hanna, S. J.; Kaiser, L. R.; Muneer, Asıf; Nottingham, J.; Kunkler, R.

doi:10.1016/j.ygyno.2004.09.003

Cited by 9 publications

(4 citation statements)

References 8 publications

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“…Bladder cancer treatment can affect the lymphatic system and cause retrograde lymphatic spread of cancerous cells. 12,13 Cutaneous metastases are usually associated with advanced metastatic disease and indicate a very poor prognosis. 2,10 Spread to the skin is thought to be from implantation, after surgical removal of the primary, or haematogenous spread.…”

Section: Discussionmentioning

confidence: 99%

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Labia majora metastasis secondary to transitional cell cancer of the bladder – a rare cutaneous manifestation of a common urological neoplasm

El-Sheemy¹,

Seddon²,

Lacey³

et al. 2014

Journal of Clinical Urology

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An 82-year-old female underwent anterior exenteration, ileal conduit formation and bilateral lymphadenectomy for definitive treatment of high-grade bladder transitional cell carcinoma (TCC) with muscle invasion (G3 pT2). On initial diagnosis, transurethral resection of bladder tumour (TURBT) and a cycle of mitomycin C were performed. Staging computed tomography (CT) confirmed the tumour was organ confined. The patient also had hypertension, chronic kidney disease stage 3 and a left pelvic kidney. She had an anterior resection performed for a colonic fistula secondary to diverticular disease.After surgery, she was sixteen followed up regularly in clinic with CT scans at nine, and twenty-four months. Ten months following her last scan, she attended clinic with a painful lymph node in the right groin. Biopsy revealed poorly differentiated carcinoma consistent with metastatic bladder TCC. CT scan showed enlarged right inguinal lymph nodes and less prominent left inguinal lymph nodes. Incidentally, in the same month, she had presented to her general practitioner experiencing offensive smelling, blood-stained vaginal discharge. Examination found a 1 cm ulcerated, cystic lesion on the anterior tip of the right labia majora. This prompted referral to the gynaecology team and a wedge biopsy was performed. Pathological analysis revealed intact, non-dysplastic squamous cell epithelium of vulval mucosa with an underlying nodule of poorly differentiated carcinoma (see Figures 1 and 2). The biopsy was consistent with a metastasis from TCC of the bladder. The margins were negative. Results prompted referral back to the urology team for wide local excision of the cyst.She became under joint urological and oncology care and was seen regularly in their clinic. Six months later, a small palpable, hard nodule adjacent to the patient's stoma was found. Biopsy consequently confirmed another metastatic TCC.She was referred to palliative care services and died four years following diagnosis. DiscussionThis is the first reported case of TCC metastasis to the labia majora in literature following a PubMed and OVID review back to 1955.Labia majora metastasis secondary to transitional cell cancer of the bladdera rare cutaneous manifestation of a common urological neoplasm

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Section: Discussionmentioning

confidence: 99%

“…Bladder cancer treatment can affect the lymphatic system and cause retrograde lymphatic spread of cancerous cells. 12,13…”

Section: Discussionmentioning

confidence: 99%

Labia majora metastasis secondary to transitional cell cancer of the bladder – a rare cutaneous manifestation of a common urological neoplasm

El-Sheemy¹,

Seddon²,

Lacey³

et al. 2014

Journal of Clinical Urology

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“…In the literature, clitoral priapism because of TCC metastase which causes vascular stasis and a squamous cell carcinoma of the bladder which presents as cliteromegaly with lymphatic and vascular stasis are reported [8,9]. It is also said that lymphatic spread can be possible after extensive radical pelvic surgery or radiation therapy by retrograde spread to the vulvar lymphatics which ocurred because of the newly formed lymphatic stasis.…”

Section: Discussionmentioning

confidence: 99%

Transitional cell carcinoma of the clitoris: direct implantation or metastasis

et al. 2006

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Transitional cell carcinoma (TCC) of the bladder is the seventh most frequent cancer of women. The possible mechanisms of local tumor recurrence are seeding and multicentricity. Distant metastases are most frequently as a result of vascular or lymphatic spread and to a lesser extent by seeding of the tumor cells with urine or transurethral instrumentation. We report a clitoral metastasis of a TCC of the bladder, which is a very unexpected and extremely rare site for metatstasis and discuss whether the possible mechanism is vascular spreading or direct seeding. To our knowledge this is the third case in the literature.

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“…Carcinoma of the stomach (11) 3 Rectal cancer (12) 4 Kidney cancer (13) 5 Transitional cell carcinoma of the renal pelvis (14) 6 Transitional cell carcinoma of the bladder (15) 7 Carcinoma of the bladder (16) 8 Squamous cell carcinoma of the bladder (17) 9 Squamous cell carcinoma of the cervix (18) 10 Low-grade ESS (case of our study)…”

Section: Accepted For Publication June 1 2006mentioning

confidence: 92%

Metastatic low-grade endometrial stromal sarcoma of clitoris: report of a case

Androulaki

Papathomas

Alexandrou

et al. 2007

Int J Gynecol Cancer

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Low-grade endometrial stromal sarcoma (ESS) is an uncommon neoplasm, which has a highly recurrent nature. A review of the literature revealed that only one case of low-grade ESS, arising within the vulva from a focus of endometriosis, has been previously published. We describe an additional case of low-grade ESS arising within the vulva and to the best of our knowledge the first report of low-grade ESS metastasized to clitoris. A 46-year-old woman was admitted to our hospital due to a heavy uterine bleeding. A physical examination revealed a lesion in clitoris, which exhibited a densely cellular mesenchymal neoplasm on microscopy. On the basis of the pathologic features alone, a differential diagnosis of a low-grade ESS and cellular leiomyoma was considered. Seven months later, the patient presented again with excessive uterine bleeding and a total hysterectomy was performed. A tumor of white-tan, whorled appearance was found. Its features were suggestive of low-grade ESS. Taking into account the possible extrauterine location of an ESS and reviewing the first case, a diagnosis of rare low-grade ESS metastasized to clitoris was made.

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Squamous cell carcinoma of the bladder presenting as vulvitis and cliteromegaly

Cited by 9 publications

References 8 publications

Labia majora metastasis secondary to transitional cell cancer of the bladder – a rare cutaneous manifestation of a common urological neoplasm

Labia majora metastasis secondary to transitional cell cancer of the bladder – a rare cutaneous manifestation of a common urological neoplasm

Transitional cell carcinoma of the clitoris: direct implantation or metastasis

Metastatic low-grade endometrial stromal sarcoma of clitoris: report of a case

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