Download PDF
Aktuelle Urol
DOI: 10.1055/a-2383-0663
Fallbericht

Ein äußerst seltener Fall von multiplen Rezidiven eines Urothelzellkarzinoms in einer ilealen Neoblase: Fallbericht und Literaturübersicht

An extremely rare case of multiple recurrences of urothelial carcinoma in an ileal neobladder: a case report and review of the literature
Silvia Clauser
1   Department of Urology, Hospital of Bolzano, EBU Center, Teaching Hospital of Paracelsus Medical Universitiy (PMU), Bolzano, Italy
,
Margherita Palermo
2   Faculty of Medicine, University of Latvia, Riga, Latvia (Ringgold ID: RIN61769)
,
Salvatore Palermo
1   Department of Urology, Hospital of Bolzano, EBU Center, Teaching Hospital of Paracelsus Medical Universitiy (PMU), Bolzano, Italy
,
Evi Comploj 
1   Department of Urology, Hospital of Bolzano, EBU Center, Teaching Hospital of Paracelsus Medical Universitiy (PMU), Bolzano, Italy
,
Esther Hanspeter
3   Department of Histopathology, Hospital of Bolzano, Teaching Hospital of Paracelsus Medical Universitiy (PMU), Bolzano, Italy
,
Christine Mian
3   Department of Histopathology, Hospital of Bolzano, Teaching Hospital of Paracelsus Medical Universitiy (PMU), Bolzano, Italy
,
Emanuela Trenti 
1   Department of Urology, Hospital of Bolzano, EBU Center, Teaching Hospital of Paracelsus Medical Universitiy (PMU), Bolzano, Italy
,
Sara Krüger
1   Department of Urology, Hospital of Bolzano, EBU Center, Teaching Hospital of Paracelsus Medical Universitiy (PMU), Bolzano, Italy
,
Philipp Krause
1   Department of Urology, Hospital of Bolzano, EBU Center, Teaching Hospital of Paracelsus Medical Universitiy (PMU), Bolzano, Italy
,
Giovanni Mazzucato
1   Department of Urology, Hospital of Bolzano, EBU Center, Teaching Hospital of Paracelsus Medical Universitiy (PMU), Bolzano, Italy
,
Armin Pycha
1   Department of Urology, Hospital of Bolzano, EBU Center, Teaching Hospital of Paracelsus Medical Universitiy (PMU), Bolzano, Italy
4   Sigmund Freud Private University, Medical School, Vienna, Austria
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Zusammenfassung

In bis zu 18% tritt nach kurativer radikaler Zystektomie wegen eines Urothelkarzinoms ein Rezidiv auf. Zumeist manifestieren sich die Rezidive in den regionären Lymphknoten oder im verbliebenen oberen oder unteren Harntrakt. Extrem selten tritt ein Rezidiv in einer Neoblase auf, zumal es sich um ein anderes embryonales Keimblatt handelt.

Wir berichten über einen Fall, bei dem 10 Jahre nach der Zystoprostatektomie multiple Urothelkarzinomrezidive nur in der Neoblase auftraten. Daraufhin wurde die Neoblase entfernt und ein Sigma-Conduit angelegt. Trotzdem trat 6 Monate später eine generalisierte Metastasierung auf, woran der Patient wenig später verstarb. Zurzeit gibt es aufgrund der Seltenheit dieses Krankheitsbilds keine Behandlungsrichtlinien. Wir schildern unsere Erfahrungen und geben eine Literaturübersicht.

Abstract

In up to 18% of patients, recurrence is observed after curative radical cystectomy. Tumour recurrence occurs in most cases in the locoregional lymph node, as well as in the remaining urinary tract, but very rarely in the orthotopic neobladder.

We report a case of multiple recurrence of urothelial carcinoma solely in the orthotopic neobladder of a male patient, 10 years after surgery, without involvement of the urethra or upper urinary tract. Therefore, the patient underwent resection of the neobladder with conversion to a sigmoid conduit. Nevertheless approximately 6 months later the patient developed widespread metastases and died a few months later.

Currently, no guidelines are available for the treatment of these rare cases.

We present our experience, together with revision of the current literature on this issue.

Schlüsselwörter

Urothelzellkarzinom - Rezidiv - Neoblase - transurethrale Resektion - Metastasen

Keywords

transitional cell carcinoma - recurrence - neobladder - transurethral resection - secondary malignancy


Publication History

Received: 10 April 2024

Accepted after revision: 07 August 2024

Article published online:
11 September 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Stein JP, Lieskovsky G, Cote R. et al. Radical Cystectomy in the Treatment of Invasive Bladder Cancer: Long-Term Results in 1,054 Patients. J Clin Oncol 2001; 19: 666-675
    CrossrefPubMedSearch in Google Scholar
  • 2 Witjes JA, Bruins HM, Cathomas R. et al. European Association of Urology Guidelines on Muscle-invasive and Metastatic Bladder Cancer: Summary of the 2020 Guidelines. Eur Urol 2021; 79: 82-104
    CrossrefPubMedSearch in Google Scholar
  • 3 Chang SS, Bochner BH, Chou R. et al. Treatment of Non-Metastatic Muscle-Invasive Bladder Cancer: Aua/Asco/Astro/Suo Guideline. J Urol 2017; 198: 552-559
    CrossrefPubMedSearch in Google Scholar
  • 4 Dadikhi K, Mueller F, Montani M. et al. Case of the Month from the University Hospital of Bern, Switzerland: Urothelial carcinoma in an orthotopic neobladder: reported cases and pathophysiological hypotheses. BJU Int 2022; 130: 38-42
    CrossrefPubMedSearch in Google Scholar
  • 5 Sanderson KM, Cai J, Miranda G. et al. Upper tract urothelial recurrence following radical cystectomy for transitional cell carcinoma of the bladder: an analysis of 1,069 patients with 10-year followup. J Urol 2007; 177: 2088-2094
    CrossrefPubMedSearch in Google Scholar
  • 6 Picozzi S, Ricci C, Gaeta M. et al. Upper Urinary Tract Recurrence Following Radical Cystectomy for Bladder Cancer: A Meta-Analysis on 13,185 Patients. J Urol 2012; 188: 2046-2054
    CrossrefPubMedSearch in Google Scholar
  • 7 Oosterlinck W. Guidelines on diagnosis and treatment of superficial bladder cancer. Minerva Urol E Nefrol Ital J Urol Nephrol 2004; 56: 65-72
    PubMedSearch in Google Scholar
  • 8 Sylvester RJ, Oosterlinck W, Witjes JA. The Schedule and Duration of Intravesical Chemotherapy in Patients with Non-Muscle-Invasive Bladder Cancer: A Systematic Review of the Published Results of Randomized Clinical Trials. Eur Urol 2008; 53: 709-719
    CrossrefPubMedSearch in Google Scholar
  • 9 Babjuk M, Oosterlinck W, Sylvester R. et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder, the 2011 update. Eur Urol 2011; 59: 997-1008
    CrossrefPubMedSearch in Google Scholar
  • 10 Jones TD, Wang M, Eble JN. et al. Molecular Evidence Supporting Field Effect in Urothelial Carcinogenesis. Clin Cancer Res 2005; 11: 6512-6519
    CrossrefPubMedSearch in Google Scholar
  • 11 Willenbrink TJ, Ruiz ES, Cornejo CM. et al. Field cancerization: Definition, epidemiology, risk factors, and outcomes. J Am Acad Dermatol 2020; 83: 709-717
    CrossrefPubMedSearch in Google Scholar
  • 12 Gaisa NT. Tumorigenesis from a pathological perspective: Tumor spread and epigenetically regulated genes in bladder cancer. Pathol 2016; 37: 196-203
    CrossrefPubMedSearch in Google Scholar
  • 13 Goenka A, Khan F, Verma B. et al. Tumor microenvironment signaling and therapeutics in cancer progression. Cancer Commun 2023; 43: 525-561
    CrossrefPubMedSearch in Google Scholar
  • 14 Pycha A, Mian C, Hofbauer J. et al. Multifocality of transitional cell carcinoma results from genetic instability of entire transitional epithelium. Urology 1999; 53: 92-97
    CrossrefPubMedSearch in Google Scholar
  • 15 Zattoni F, Bednarova I, Morlacco A. et al. Transitional cell carcinoma recurrence impacting intestinal diversion after radical cystectomy. Oncologic outcomes of a rare site of recurrence. Cent Eur J Urol 2020; 73: 445-456
    CrossrefPubMedSearch in Google Scholar
  • 16 Stein JP, Clark P, Miranda G. et al. Urethral tumor recurrence following cystectomy and urinary diversion: clinical and pathological characteristics in 768 male patients. J Urol 2005; 173: 1163-1168
    CrossrefPubMedSearch in Google Scholar
  • 17 Fahmy O, Khairul-Asri MG, Schubert T. et al. Urethral recurrence after radical cystectomy for urothelial carcinoma: A systematic review and meta-analysis. Urol Oncol Semin Orig Investig 2018; 36: 54-59
    CrossrefPubMedSearch in Google Scholar
  • 18 Kawamoto B, Honda M, Iwamoto H. et al. Urothelial Carcinoma Recurrence at an Ileal Orthotopic Neobladder and Unilateral Lower Ureter After Surgery. Urol Case Rep 2016; 9: 27-29
    CrossrefPubMedSearch in Google Scholar
  • 19 Ide H, Kikuchi E, Shinoda K. et al. Carcinoma in situ developing in an ileal neobladder. Urology 2007; 69: 576.e9-576.e11
    CrossrefPubMedSearch in Google Scholar
  • 20 Hadzi-Djokić J, Pejcić T, Andrejević V. et al. Transitional cell carcinoma in orthotopic ileal neobladder 12 years after radical cystectomy. Vojnosanit Pregl 2013; 70: 1062-1064
    CrossrefPubMedSearch in Google Scholar
  • 21 Moore CD, Iczkowski KA, Blue KM. et al. Urothelial carcinoma recurrence in ileal orthotopic neobladder: urethrectomy and creation of ileal conduit. Urology 2007; 69: 184.e11-184.e13
    CrossrefPubMedSearch in Google Scholar
  • 22 Yamashita R, Matsuzaki M, Niwakawa M. et al. Bacillus Calmette-Guérin treatment of urothelial carcinoma arising in the ileal neobladder after radical cystectomy. Int J Urol Off J Jpn Urol Assoc 2014; 21: 333-334
    CrossrefPubMedSearch in Google Scholar
  • 23 Cakmak O, Tarhan H, Celik O. et al. Transitional cell carcinoma in orthotopic ileal neobladder. Case Rep Urol 2014; 2014: 218615
    CrossrefPubMedSearch in Google Scholar
  • 24 Cherbanyk F, Prod’homme M, Pezzetta E. et al. Urothelial Carcinoma Recurrence in an Ileal Neobladder Nine Years after Primary Surgery with Muir-Torre Syndrome. Case Rep Urol 2016; 2016: 4762514
    CrossrefPubMedSearch in Google Scholar
  • 25 Doshi CP, Barkan GA, Quek ML. Urothelial Carcinoma Recurrence in an Orthotopic Neobladder without Urethral or Upper Urinary Tract Involvement. Case Rep Urol 2019; 2019: 8458706
    CrossrefPubMedSearch in Google Scholar
  • 26 Groen VH, Lock TMTWT, Keizer B de. et al. Urothelial carcinoma in an orthotopic neobladder: an unusual pattern of recurrence and metastasis. BMJ Case Rep 2017; 2017: bcr2017221052-bcr
    CrossrefPubMedSearch in Google Scholar
  • 27 Pardalidis PN, Andriopoulos NA, Kosmaoglou EV. et al. Urothelial Carcinoma Recurrence in an Ileal Orthotopic Neobladder 10 Years After Primary Robotic Radical Cystoprostatectomy. J Endourol Case Rep 2020; 6: 16-18
    CrossrefPubMedSearch in Google Scholar
  • 28 Moeen AM. Recurrence of isolated transitional cell carcinoma in an orthotopic ileal neobladder: A case report. Afr J Urol 2015; 21: 214-216
    CrossrefPubMedSearch in Google Scholar
  • 29 Sánchez zalabardo D, López Ferrandis J, Arocena García-Tapia J. et al. Recidiva de tumor urotelial en neo-vejiga ortotópica. Actas Urol Esp 2001; 25: 600-602
    CrossrefPubMedSearch in Google Scholar
  • 30 Barba Abad JF, Tolosa Eizaguirre E, Rincón Mayans A. et al. Tumor relapse in orthotopic bladder replacement. A report of two cases and literature review. Actas Urol Esp 2010; 34: 295-297
    PubMedSearch in Google Scholar
  • 31 Frese R, Doehn C, Baumgärtel M. et al. Carcinoid tumor in an ileal neobladder. J Urol 2001; 165: 522-523
    CrossrefPubMedSearch in Google Scholar
  • 32 Hara I, Hara S, Miyake H. et al. Carcinoma in situ spread to mucosa of sigmoid colon neobladder. Urology 2003; 62: 145
    CrossrefPubMedSearch in Google Scholar
  • 33 Herawi M, Leppert JT, Thomas GV. et al. Implants of noninvasive papillary urothelial carcinoma in peritoneum and ileocolonic neobladder: support for „seed and soil“ hypothesis of bladder recurrence. Urology 2006; 67: 746-750
    CrossrefPubMedSearch in Google Scholar
  • 34 Kotb A, Alkosiry M, AbdElkawy N. et al. Late recurrent urothelial carcinoma in the Studer neobladder: conversion to continent reservoir. ecancermedicalscience 2012; 6: 268
    CrossrefPubMedSearch in Google Scholar
  • 35 Fujimoto T, Sakamoto H, Sakurai T. et al. Squamous cell and urothelial carcinomas in an ileal neobladder. IJU Case Rep 2022; 5: 141-144
    CrossrefPubMedSearch in Google Scholar
  • 36 Kälble T, Hofmann I, Riedmiller H. et al. Tumor growth in urinary diversion: a multicenter analysis. Eur Urol 2011; 60: 1081-1086
    CrossrefPubMedSearch in Google Scholar
  • 37 Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF). S3-Leitlinie Früherkennung, Diagnose, Therapie und Nachsorge des Harnblasenkarzinoms. AWMF-Registernummer: 032/038OL: 1–400. 2020
    PubMedSearch in Google Scholar
  • 38 Soukup V, Babjuk M, Bellmunt J. et al. Follow-up after surgical treatment of bladder cancer: a critical analysis of the literature. Eur Urol 2012; 62: 290-302
    CrossrefPubMedSearch in Google Scholar