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Muacevic A, Adler JR, Kalra S, Dorairajan LN, Sreenivasan Kodakkattil S. Sarcomatoid Urothelial Carcinoma of the Urinary Bladder With Chondrosarcomatous and Concurrent Divergent Squamous Cell Carcinoma Differentiation- A Rare Entity. Cureus 2022; 14:e33107. [PMID: 36721592 PMCID: PMC9884181 DOI: 10.7759/cureus.33107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2022] [Indexed: 12/31/2022] Open
Abstract
We present an extremely rare case where the sarcomatoid urothelial carcinoma of the urinary bladder was present with chondrosarcomatous and squamous cell differentiation. A 74-year-old male smoker presented with intermittent hematuria with the passage of clots. On imaging, an irregular polypoidal lesion was diagnosed near the right vesicoureteric junction, and transurethral resection of the bladder tumor was performed. Histopathological examination showed sarcomatoid urothelial carcinoma with chondrosarcoma and squamous cell differentiation. He refused the surgical treatment of radical cystectomy and underwent Gemcitabine and Cisplatin chemotherapy. He died nine months after the diagnosis. Sarcomatoid urothelial carcinoma is a high-grade biphasic neoplasm with malignant epithelial and mesenchymal components. Its association with squamous cell carcinoma is infrequent. It is very aggressive, and there is no standard treatment for this disease. The radical surgical option appears to be the main form of treatment. It is scarce with a grave prognosis.
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Isaacson D, Steggerda J, Xue Y, Wren J, Javeed Ansari M, Auffenberg GB, Katariya N. Donor-derived duodenal adenocarcinoma of a bladder-drained pancreas allograft. Am J Transplant 2022; 22:2265-2268. [PMID: 35325501 PMCID: PMC9543768 DOI: 10.1111/ajt.17042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/16/2022] [Accepted: 03/21/2022] [Indexed: 01/25/2023]
Abstract
The subset of the population that received bladder-drained allograft pancreata during peak utilization of the technique in the 1990s is approaching 20-30 postoperative years. This time frame is salient, as it parallels the time in which patients in the urologic literature develop adenocarcinomas after bladder reconstruction using gastrointestinal segments. We present the case of a 57-year-old simultaneous pancreas/kidney recipient who presented with microhematuria twenty-four years after transplantation and was found to have an adenocarcinoma of the duodenum of his failed, bladder-drained pancreas. After allograft pancreatectomy/duodenectomy, he remains disease-free eleven months postoperatively. As this patient population ages, practitioners should consider pathology of the donor duodenum and pancreas in recipients who present with gross or microscopic hematuria.
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Affiliation(s)
- Dylan Isaacson
- Department of SurgeryComprehensive Transplant CenterNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of UrologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Justin Steggerda
- Department of SurgeryComprehensive Transplant CenterNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Yue Xue
- Department of PathologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - James Wren
- Department of UrologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Mohammed Javeed Ansari
- Department of SurgeryComprehensive Transplant CenterNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Division of Nephrology and HypertensionDepartment of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | | | - Nitin Katariya
- Department of Surgery, Division of Transplant and Hepatobiliary SurgeryMayo Clinic, Alix School of MedicinePhoenixArizonaUSA
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Conservative Management of Muscle Invasive Bladder Cancer in Kidney-Pancreas Transplant Patient. Case Rep Transplant 2022; 2022:5373414. [PMID: 35677063 PMCID: PMC9168198 DOI: 10.1155/2022/5373414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 05/06/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction. Solid organ transplant increases the risk for muscle-invasive bladder cancer (MIBC). Although a common tumor, urothelial cell carcinoma (UCC) of the bladder in patients with kidney-pancreas transplants is scarcely reported. Case Presentation. A 65-year-old male with history of type 1 diabetes and a 14-year status post deceased donor pancreas-kidney transplant presented with 3 weeks of gross hematuria. CT scan showed multiple bladder masses. Transurethral resection of bladder tumor (TURBT) showed papillary UCC. 5 months later, the patient reported new-onset gross hematuria. TURBT showed MIBC. The patient elected for bladder-preserving TMT. On cystoscopy there was no gross evidence of carcinoma at 3.5 years of follow up. Discussion. Currently, no specific management guidelines target this population with MIBC. The first-line treatment for MIBC is radical cystectomy (RC) with neoadjuvant chemotherapy. For patients that are medically unfit or unwilling to undergo RC, trimodal therapy (TMT) is an alternative. TMT for bladder cancer consists of complete tumor resection with chemotherapy and radiation. This report demonstrates a unique case of a patient with kidney-pancreas transplant diagnosed with MIBC treated with TMT that has no evidence of gross tumorigenesis at 3.5 years after diagnosis. Our findings suggest that trimodal therapy should be considered for treatment of MIBC in patients with kidney-pancreatic transplants to preserve the donated allografts.
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Li ZK, Chen Y, Yang Y, Cheng K, Li ZP, Liu JY. Gemcitabine and Paclitaxel for Primary Bladder Carcinoma in Renal Transplant Recipients: A Case Report. Clin Genitourin Cancer 2016; 14:e423-5. [PMID: 27017467 DOI: 10.1016/j.clgc.2016.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 02/14/2016] [Indexed: 02/05/2023]
Affiliation(s)
- Zhi-Ke Li
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Ye Chen
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Yu Yang
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Ke Cheng
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Zhi-Ping Li
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Ji-Yan Liu
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, People's Republic of China.
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