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Keane Tahmaseb GC, Keane AM, Foppiani JA, Myckatyn TM. An Update on Implant-Associated Malignancies and Their Biocompatibility. Int J Mol Sci 2024; 25:4653. [PMID: 38731871 PMCID: PMC11083590 DOI: 10.3390/ijms25094653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/14/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Implanted medical devices are widely used across various medical specialties for numerous applications, ranging from cardiovascular supports to orthopedic prostheses and cosmetic enhancements. However, recent observations have raised concerns about the potential of these implants to induce malignancies in the tissues surrounding them. There have been several case reports documenting the occurrence of cancers adjacent to these devices, prompting a closer examination of their safety. This review delves into the epidemiology, clinical presentations, pathological findings, and hypothesized mechanisms of carcinogenesis related to implanted devices. It also explores how the surgical domain and the intrinsic properties and biocompatibility of the implants might influence the development of these rare but serious malignancies. Understanding these associations is crucial for assessing the risks associated with the use of medical implants, and for developing strategies to mitigate potential adverse outcomes.
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Affiliation(s)
- Grace C. Keane Tahmaseb
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
| | - Alexandra M. Keane
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
| | - Jose A. Foppiani
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
| | - Terence M. Myckatyn
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
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Sawazaki H, Kitamura Y, Asano A, Ito Y, Tsuda H. A case of squamous cell carcinoma arising from a suprapubic cystostomy tract in a patient with spinal bifida: Immunohistochemical analysis and literature review. IJU Case Rep 2022; 6:60-64. [PMID: 36605696 PMCID: PMC9807353 DOI: 10.1002/iju5.12554] [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] [Received: 06/15/2022] [Accepted: 10/22/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Squamous cell carcinoma arising from a suprapubic cystostomy tract is a rare complication of an indwelling catheter and is caused by long-term inflammation and mechanical irritation. Prognosis is relatively poor. Biomarkers in the cancer pathway have not been investigated. Case presentation A 61-year-old woman with a 34-year history of suprapubic catheter placement presented with a rapidly growing elevated lesion around the cystostomy site. Tumor biopsy confirmed squamous cell carcinoma. Local excision with partial cystectomy was performed. Multiple metastases were identified 5 months later. The patient died 14 months after the initial treatment. Immunohistochemical analysis of the resected specimen revealed alterations in vascular endothelial growth factor, epidermal growth factor receptor, cyclooxygenase-2, and Ki-67. Conclusion We encountered a case of squamous cell carcinoma arising from a suprapubic cystostomy tract. Immunohistochemical analysis revealed activation of multiple carcinogenic pathways in cancer cells, including those for angiogenesis, signal transduction by epidermal growth factor receptor, inflammation, and cell proliferation.
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Affiliation(s)
| | - Yosuke Kitamura
- Department of UrologyTama‐Hokubu Medical CenterHigashimurayamaJapan
| | - Atsushi Asano
- Department of UrologyNational Defense Medical CollegeTokorozawaJapan
| | - Yuji Ito
- Department of PathologyTama‐Hokubu Medical CenterHigashimurayamaJapan
| | - Hitoshi Tsuda
- Department of Basic PathologyNational Defense Medical CollegeTokorozawaJapan
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3
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Abstract
The combination of a severe urethral sphincter defect with simultaneous development of recurrent bladder outlet obstruction characterizes a "devastated bladder outlet", which often is not surgically reconstructable. Clinically, quality of life is considerably compromised in affected patients with a wide variance of symptoms, mostly complete incontinence, but also urinary retention. This condition is usually preceded by multiple endoscopic interventions or even open surgical procedures, occasionally also in combination with radiotherapy of the pelvic region as part of multimodal oncological therapy. Treatment of these cases is complex and limited to few promising procedures. A potential therapy should primarily include the decision about the possibility of preserving the urinary bladder. In individual cases, this can result in simple therapy options while at the same time maintaining an acceptable quality of life for those affected. If there is no possibility of a refunctionalization of the original bladder, supravesical urinary diversion is indicated as a last-resort therapy. This paper provides a review as well as the limits and possibilities of conservative and surgical treatment options for a devastated bladder outlet.
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Affiliation(s)
- A Kocot
- Klinik und Poliklinik für Urologie und Kinderurologie, Julius Maximilians Universität Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.
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Prattley S, New F, Davies M. Malignancies of suprapubic catheter (SPC) tracts in spinal cord injury patients: a case series and review of literature. Spinal Cord Ser Cases 2019; 5:34. [PMID: 31240127 PMCID: PMC6474306 DOI: 10.1038/s41394-019-0177-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 11/28/2022] Open
Abstract
Introduction Spinal cord injury (SCI) patients are at increased risk of bladder cancer. A rare variation of this is a malignancy arising or including the suprapubic catheter (SPC) tract. Case series We present the first case series of malignancy of the SPC tract in SCI patients, including a case of mucinous adenocarcinoma, squamous cell carcinoma and sarcoma. Presentation of patients ranged from bleeding at the site of the SPC to a rapidly growing mass. All three patients were thoroughly investigated, and management was bespoke to the extent of disease and their physiological state at the time of diagnosis. This ranged from extensive surgical intervention including cystectomy, partial sigmoidectomy, excision of the abdominal wall with reconstruction and ileal conduit formation to palliation. Discussion SCI patients represent 50% of all known published cases of malignancy of the SPC tract. Presentation and diagnosis can be challenging; however, prompt investigation and intervention are essential given the high degree of morbidity and mortality. Routine check of the SPC site may be indicated in those patients in whom the SPC has been present for more than 5 years.
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Affiliation(s)
- Sarah Prattley
- Salisbury District Hospital, Odstock Road, Salisbury, SP28BJ UK
| | - Francesca New
- Salisbury District Hospital, Odstock Road, Salisbury, SP28BJ UK
| | - Melissa Davies
- Salisbury District Hospital, Odstock Road, Salisbury, SP28BJ UK
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Zheng D, Williams C, Vold JA, Nguyen JH, Harnois DM, Bagaria SP, McLaughlin SA, Li Z. Regulation of sex hormone receptors in sexual dimorphism of human cancers. Cancer Lett 2018; 438:24-31. [PMID: 30223066 PMCID: PMC6287770 DOI: 10.1016/j.canlet.2018.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/24/2018] [Accepted: 09/03/2018] [Indexed: 02/07/2023]
Abstract
Gender differences in the incidences of cancers have been found in almost all human cancers. However, the mechanisms that underlie gender disparities in most human cancer types have been under-investigated. Here, we provide a comprehensive overview of potential mechanisms underlying sexual dimorphism of each cancer regarding sex hormone signaling. Fully addressing the mechanisms of sexual dimorphism in human cancers will greatly benefit current development of precision medicine. Our discussions of potential mechanisms underlying sexual dimorphism in each cancer will be instructive for future cancer research on gender disparities.
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Affiliation(s)
- Daoshan Zheng
- Department of Cancer Biology, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Cecilia Williams
- Department of Biosciences and Nutrition, KTH Royal Institute of Technology, Karolinska Institutet, Science for Life Laboratory, Stockholm, Sweden
| | - Jeremy A Vold
- Mayo Cancer Registry, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Justin H Nguyen
- Department of Surgery, and Mayo Clinic Cancer Center, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Denise M Harnois
- Department of Surgery, and Mayo Clinic Cancer Center, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Sanjay P Bagaria
- Department of Surgery, and Mayo Clinic Cancer Center, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Sarah A McLaughlin
- Department of Surgery, and Mayo Clinic Cancer Center, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Zhaoyu Li
- Department of Cancer Biology, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
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Khadhouri S, Rye DS, Powari M, Daniels IR, McGrath JS. A case report of squamous cell carcinoma in a suprapubic urinary catheter tract: surgical excision and simultaneous colostomy formation. J Surg Case Rep 2018; 2018:rjy030. [PMID: 29492256 PMCID: PMC5824828 DOI: 10.1093/jscr/rjy030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 02/07/2018] [Indexed: 11/13/2022] Open
Abstract
Squamous cell carcinoma (SCC) arising from a suprapubic cystostomy tract is a rare complication of long-term suprapubic catheterization (SPC). A 53-year-old man with paraplegia secondary to spina bifida presented with a painful granulomatous lesion around his SPC site that was being treated with silver nitrate cauterization in the community. Consequently, he developed a sacral pressure sore due to reduced mobility from the pain. He also had increasing difficulties with defaecation secondary to his spina bifida. His sacral pressure sore was secondary to a cryptoglandular fistula with coccygeal osteomylelitis. Post-operative pathology revealed infiltrative SCC involving full thickness of the specimen from skin to the bladder wall with clear surgical margins. We describe the first case requiring a simultaneous suprapubic tract SCC excision and colostomy formation. We recommend early investigation of lesions arising from a long-term suprapubic tract especially in patients with spinal cord injuries or congenital defects.
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Affiliation(s)
- Sinan Khadhouri
- Department of Urology, Royal Devon & Exeter Hospital, Exeter EX2 5DW, UK
| | | | - Manish Powari
- Department of Pathology, Royal Devon & Exeter Hospital, Exeter EX2 5DW, UK
| | - Ian R Daniels
- Department of Colorectal Surgery, Royal Devon & Exeter Hospital, Exeter EX2 5DW, UK
| | - John S McGrath
- Department of Urology, Royal Devon & Exeter Hospital, Exeter EX2 5DW, UK
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Squamous Cell Carcinoma of Suprapubic Cystostomy Site in a Patient with Long-Term Suprapubic Urinary Catheter. Case Rep Urol 2017; 2017:7940101. [PMID: 29259836 PMCID: PMC5702393 DOI: 10.1155/2017/7940101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/03/2017] [Accepted: 10/10/2017] [Indexed: 11/19/2022] Open
Abstract
Patients with long-term suprapubic cystostomy can rarely develop squamous cell carcinoma (SCC) of the suprapubic cystostomy tract. In addition to the few reported cases in the literature, this paper reports a case of suprapubic cystostomy SCC in an 88-year-old man without bladder involvement. Vigilance about any abnormal lesion at the site of suprapubic cystostomy is important among health providers and patients for early detection of SCC.
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Vallée M, Luyckx F. Sondage sur les sondages : us et coutumes des infirmiers en France. Prog Urol 2016; 26:865-870. [DOI: 10.1016/j.purol.2016.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 08/16/2016] [Accepted: 08/23/2016] [Indexed: 11/25/2022]
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Bauman TM, Potretzke TA, Potretzke AM, Siegel CL, Brandes SB. Mucinous adenocarcinoma of the bladder associated with long term suprapubic tube: a case report. BMC Urol 2015; 15:119. [PMID: 26630940 PMCID: PMC4668653 DOI: 10.1186/s12894-015-0112-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic indwelling catheters may induce histologic changes within the bladder, and these changes are sometimes pre-malignant. There are many documented cases of squamous cell carcinoma associated with indwelling catheters, but only three cases of catheter-associated adenocarcinoma have been reported. In this case report, we present radiographic findings of a case of mucinous adenocarcinoma of the bladder and suprapubic (SP) tract in a quadriplegic patient. CASE PRESENTATION A 71-year-old male with a history of spinal cord injury presented with hematuria and SP discharge after SP catheterization for 51 years. CT urography was performed and revealed an irregular, infiltrative, and heterogeneous mass arising from the anterior bladder at the level of the suprapubic catheter and extending along the SP tube tract. Cystoscopy and biopsy revealed an adenocarcinoma of the anterior bladder and stoma with extensive associated mucin production and a background of acute and chronic inflammation. Surgical therapy included cystoprostatectomy, abdominal wall resection, ileal conduit creation, and abdominal wall reconstruction. The final diagnosis was a high-grade, T2a/N0/M0 (Stage II) mucinous adenocarcinoma of the bladder. There has been no evidence of tumor recurrence over the previous 5 years. CONCLUSION Few cases of adenocarcinoma associated with long term indwelling catheter have been reported in the literature, and due to the rarity of this disease process, the prognosis with surgical therapy is not well known. The patient described herein has been free of recurrence for the previous five years, suggesting that surgery is a viable management option for these patients.
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Affiliation(s)
- Tyler M Bauman
- Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
| | - Theodora A Potretzke
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Aaron M Potretzke
- Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
| | - Cary L Siegel
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Steven B Brandes
- Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
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