Cerebellar Single Metastases from Bladder Transitional Cell Carcinoma: A Case Report

Abstract

Cerebral metastasis is the most common cancer in the Central Nervous System (CNS); however, the bladder is a rare primary origin. The incidence of bladder metastases to the brain tissue has slightly increased in the past decades, with a few case reports published in medical literature, but not in Brazil. The authors describe a case of a female with prior diagnosis and treatment of transitional cellular cancer, without signs or symptoms of local or disseminated relapse, who suddenly developed clinical signs of cerebellum impairment. The patient was submitted to neurosurgical procedure with good outcome, followed by oncologic adjuvant treatment.

Resumo

As metástases cerebrais são as patologias neoplásicas mais comuns no sistema nervoso central (SNC), contudo, o epitélio vesical é um sitio primário raro para os tumores que acometem o parênquima cerebral. A incidência do envolvimento cerebral em tumores de bexiga tem aumentado nos últimos anos, com alguns relatos de caso descritos na literatura médica, contudo nenhum caso foi descrito no Brasil. Os autores relatam o caso de uma paciente com diagnóstico de câncer de células transicionais cujo sítio primário já fora tratado previamente, sem sinais de recidiva local ou à distância, que subitamente iniciou com sinais clínicos de síndrome cerebelar. A paciente foi submetida a ressecção cirúrgica da lesão com boa evolução pós-operatória complementada com terapia oncológica adjuvante.

Keywords

urothelial carcinoma - cerebral metastases - transitional cell carcinoma

Palavras-chave

carcinoma urotelial - metástase cerebral - carcinoma de células transicionais

• References

• 1 Babaian RJ, Johnson DE, Llamas L, Ayala AG. Metastases from transitional cell carcinoma of urinary bladder. Urology 1980; 16 (2) 142-144
• 2 Rosenstein M, Wallner K, Scher H, Sternberg CN. Treatment of brain metastases from bladder cancer. J Urol 1993; 149 (3) 480-483
• 3 Steinfeld AD, Zelefsky M. Brain metastases from carcinoma of bladder. Urology 1987; 29 (4) 375-376
• 4 Protzel C, Zimmermann U, Asse E, Kallwellis G, Klebingat KJ. Gemcitabine and radiotherapy in the treatment of brain metastases from transitional cell carcinoma of the bladder: a case report. J Neurooncol 2002; 57 (2) 141-145
• 5 Erhamamcı S, Reyhan M, Altinkaya N. A case of brain and leptomeningeal metastases from urothelial carcinoma of the bladder. Rev Esp Med Nucl Imagen Mol [Internet]. SEMNIM 2014; 33 (5) 290-2 . Available from: http://linkinghub.elsevier.com/retrieve/pii/S2253654×13001893 . Accessed on Sep 20, 2015
• 6 Davies BJ, Bastacky S, Chung SY. Large cerebellar lesion as original manifestation of transitional cell carcinoma of the bladder. Urology 2003; 62 (4) 749
• 7 Lower WEWR. Primary carcinoma of bladder with metastasis to brain. Am J Med Sci 1924; 167: 434-437
• 8 Qasho R, Tommaso V, Rocchi G, Simi U, Delfini R. Choroid plexus metastasis from carcinoma of the bladder: case report and review of the literature. J Neurooncol 1999; 45 (3) 237-240
• 9 Turgut M, Akyüz O, Kaçar F. Solitary cerebral metastasis from transitional cell carcinoma of the urinary tract. J Clin Neurosci 2007; 14 (11) 1129-1132
• 10 Zigouris A, Pahatouridis D, Mihos E , et al. Solitary cystic cerebral metastasis from transitional cell carcinoma of the bladder. Acta Neurol Belg 2009; 109 (4) 322-325
• 11 Sanchez Abraham M, Guagnini M, Sousa L, Romano L, Aleman A. Metástasis cerebral de carcinoma urotelial de vejiga. Neurol Argentina. 2011; 3 (3) 186-188
• 12 Shamdas GJ, McLaren GD, Grimm T, Everson LK. Solitary cerebellar metastasis from transitional cell carcinoma of bladder. Urology 1992; 40 (1) 50-53
• 13 Sarmiento JM, Wi MS, Piao Z, Stiner ES. Solitary cerebral metastasis from transitional cell carcinoma after a 14-year remission of urinary bladder cancer treated with gemcitabine: Case report and literature review. Surg Neurol Int 2012; 3: 82
• 14 Uncu D, Arpaci F, Beyzadeoglu M , et al. Meningeal carcinomatosis: an extremely rare involvement of urinary bladder carcinoma. Tumori 2010; 96 (2) 352-354
• 15 Tadepalli S, Coleman T, Hacket LA, Liles GB. Carcinomatous meningitis: the natural history of successfully treated metastatic bladder cancer. Case Rep Oncol 2011; 4 (2) 406-412
• 16 Bloch JL, Nieh PT, Walzak MP. Brain metastases from transitional cell carcinoma. J Urol 1987; 137 (1) 97-99
• 17 Mahmoud-Ahmed AS, Suh JH, Kupelian PA , et al. Brain metastases from bladder carcinoma: presentation, treatment and survival. J Urol 2002; 167 (6) 2419-2422
• 18 Anderson TS, Regine WF, Kryscio R, Patchell RA. Neurologic complications of bladder carcinoma: a review of 359 cases. Cancer 2003; 97 (9) 2267-2272
• 19 Qasho R, Tommaso V, Rocchi G, Simi U, Delfini R. Choroid plexus metastasis from carcinoma of the bladder: case report and review of the literature. J Neurooncol 1999; 45 (3) 237-240
• 20 Dhote R, Beuzeboc P, Thiounn N , et al. High incidence of brain metastases in patients treated with an M-VAC regimen for advanced bladder cancer. Eur Urol 1998; 33 (4) 392-395
• 21 Rabadán AT, Diez B, Martínez AM , et al. Consenso para el tratamiento de las metástasis cerebrales. Rev Argent Neurocir 2006; 20 (4) 179-193
• 22 Fadul C, Misulis KE, Wiley RG. Cerebellar metastases: diagnostic and management considerations. J Clin Oncol 1987; 5 (7) 1107-1115
• 23 Albers P, Siener R, Härtlein M , et al; German TCC Study Group of the German Association of Urologic Oncology. Gemcitabine monotherapy as second-line treatment in cisplatin-refractory transitional cell carcinoma - prognostic factors for response and improvement of quality of life. Onkologie 2002; 25 (1) 47-52