Metastasis to the bladder from primary breast cancer: A case report and literature review

Breast cancer is the most prevalent malignant tumor affecting women and represents the leading cause of female cancer-related mortality worldwide. Although distant organ metastasis accounts for the majority of breast cancer-related deaths, reports on bladder metastasis are limited in the existing literature. The present study describes the case of a patient with bladder metastasis originating from breast cancer. In addition, the present study also provides a review of 54 cases of similar disease that have been documented in the currently available literature. The literature review aims to elucidate the clinicopathological characteristics and therapeutic approaches for such conditions. The median time from breast cancer diagnosis to bladder metastasis was found to be 5.6 years (range, 0-28 years). The origin of the bladder metastases was predominantly invasive ductal carcinoma (IDC) accounting for 52.3% of cases, followed by invasive lobular carcinoma, accounting for 40.9% of cases. The pathology in the primary tumor was the same as the pathology of the bladder metastases in all cases. There was an 88.9% concordance rate for estrogen receptor status, while the progesterone receptor status was 83.3% and the human epidermal growth factor receptor 2 expression status was 100%. The primary initial symptoms included urinary system manifestations, such as increased frequency, urgency, dysuria, urinary incontinence, nocturia and gross hematuria. For the cystoscopic examination, the predominant findings were bladder wall thickening or masses, along with ureteral orifice masses. Overall, the present study demonstrated that the occurrence of bladder metastasis often follows the metastasis of other organs, with IDC being the most prevalent subtype. The pathological characteristics between the primary tumor and bladder metastasis exhibit a high degree of concordance.

A case of urinary bladder metastasis of hepatocellular carcinoma following use of immunotherapy/tyrosine kinase inhibitor

Introduction

Here we present a rare case of hepatocellular carcinoma metastasis to the urinary bladder in a patient with metastatic HCC.

Case presentation

An 83-year-old man developed gross hematuria during combined treatment with an anti-programmed death-ligand 1 inhibitor and an anti-vascular endothelial growth factor for metastatic HCC. A contrast-enhanced CT revealed a 15 × 15 mm soft tissue mass protruding from the posterior bladder wall. Cystoscopy further revealed a solitary submucosal mass located on the posterior wall. The patient underwent transurethral resection of bladder tumor. The pathological findings were consistent with a diagnosis of bladder metastasis from HCC. Following a 3-week interval after the surgical intervention, salvage therapy was resumed.

Conclusion

During follow-up after TUR-BT in HCC patients who present with a bladder tumor, the possibility of HCC metastases to the urinary bladder should be excluded.

Adenocarcinoma in ectopic prostatic tissue at the trigone of urinary bladder

Introduction

Ectopic prostatic tissue is prostatic tissue located distant from the prostate gland. Although its existence is not uncommon, the occurrence of adenocarcinoma in ectopic prostatic tissue is rare.

Case presentation

A 68-year-old man was suspected to have a nodular-type tumor in the bladder trigone and a tumor in the prostate based on magnetic resonance imaging and cystoscopy results. Transurethral tumor resection and transrectal prostate needle biopsy revealed the coexistence of ectopic prostatic adenocarcinoma in the bladder trigone and low-risk orthotopic prostate cancer. Four years later, the tumor evolved to intermediate-risk prostate cancer during active surveillance, and the patient underwent prostatectomy with resection of the bladder trigone. Pathology indicated no residual ectopic prostatic tissue or adenocarcinoma at the bladder trigone.

Conclusion

Adenocarcinoma in ectopic prostatic tissue is very rare; however, when found, the possibility of concurrent cancer in the prostate gland should be considered.

Case Report: Analysis of four cases of metastatic bladder masses after radical prostatectomy

Objective

The aim of this study is to investigate the clinical characteristics and diagnostic and therapeutic methods of bladder metastasis after radical prostatectomy and to improve its diagnosis and treatment.

Methods

The clinical data of four patients with bladder metastasis after radical prostatectomy were retrospectively analyzed from January 2011 to December 2021. Three cases suffered from intermittent gross hematuria, and only one case was found to have an elevated prostate-specific antigen (PSA) value. Transurethral resection of bladder tumor was performed in four cases, in which one case also underwent resection of urethral mass. Three cases received endocrine therapy, one of which added intravesical instillation and radiation therapy. Another case received chemotherapy based on comprehensive treatment.

Results

According to the pathological and immunohistochemical results, three cases were acinar adenocarcinoma of the prostate with Gleason score of 9, and all cases were PSA positive and negative for cytokeratin 7 (CK7) and GATA binding protein 3 (GATA-3). One case was small cell neuroendocrine carcinoma of the prostate and was positive for chromogranin A (CGA), synaptophysin (SYN), and cluster of differentiation 56 (CD56). During the follow-up period of 4 to 13 months, one case was lost to follow-up and three cases were alive.

Conclusion

Bladder metastasis after radical prostatectomy is rare, and pathology combined with immunohistochemistry is the gold standard for its diagnosis. Pathological type determines its treatment. Systemic treatment is essential, and local treatment is the most palliative means. Early diagnosis and treatment is significant for better prognosis.

Lung adenocarcinoma with bladder metastasis: A case report and literature review

Background

Lung cancer is the most common cause of cancer-related mortality in the world. Unfortunately, more than 50% of patients have already metastasized at the time of diagnosis, contributing to morbidity and mortality. Common sites of metastasis are adrenal glands, liver, bone, and brain. Bladder metastasis is rare and should prompt a careful differential consideration of primary bladder cancer.

Case description

Here, we report a 72-year-old female who went to the hospital for "gross hematuria for one day". Cystoscopy showed space-occupying lesions in the bladder. During the general CT examination, space-occupying lesions in the lower lobe of the lung were found. Peripheral lung cancer with multiple lymph node metastases, pulmonary metastasis, and left pleural effusion were considered. Transurethral cystoscopic resection of the bladder tumor and pleural effusion cell block examination were performed to clarify the diagnosis. Combined with morphological and immunohistochemical results, both pathological results supported a diagnosis of lung adenocarcinoma metastasis, and gene detection was carried out. EGFR, ALK, and ROS-1 were negative. According to the genetic testing results, there was no corresponding targeted drug, so we administered chemotherapy, and one-year survival was achieved, which was better than expected based on other studies.

Conclusion

This paper describes a case of lung adenocarcinoma metastatic to the bladder and includes a review of the literature to provide clinicians with diagnostic and treatment experience and help avoid misdiagnosis and mistreatment.

Urinary bladder metastasis from suspected second primary breast cancer presenting with ambiguous lower urinary tract symptoms: A case report and literature review

Common urinary symptoms may arise from metastases from uncommon sites. In patients with a history of cancer, the focus should be on the currently affected organ and the status of the underlying malignancy.

Bladder metastasis from type 2 papillary renal cell carcinoma: A case report

Renal cell carcinoma (RCC) is a common urinary tumor that may be pathologically divided into different subtypes: clear cell RCC, papillary RCC (PRCC) and chromophobe RCC. The most common organs of RCC metastasis are the lung, liver and bones, while bladder metastasis is rare. The treatment for PRCC metastasis is also a problem due to limited clinical data. Therefore, every single case of PRCC metastasis may significantly contribute to establishing a standard treatment protocol. The present study reported on a patient who suffered from repetitive bladder PRCC metastasis with 1.5 years of follow-up. A 54-year-old male patient was diagnosed with left renal pelvic carcinoma in March 2020 and underwent a laparoscopic radical nephroureterectomy of the left kidney. The postoperative histological examination revealed that the tumor was consistent with a type 2 PRCC. Bladder metastasis was discovered three months after the surgery and transurethral resection of the bladder tumor (TURBT) was performed to eliminate the tumor in the bladder. Only three months after the initial TURBT, bladder metastasis was detected again, combined with lung metastasis. The patient refused to undergo radical cystectomy. Therefore, a second TURBT was arranged and targeted drugs were administered. However, both bladder and lung metastases were insensitive to the treatment strategy applied, although immunotherapy was subsequently added. The patient died in October 2021 due to respiratory failure and cachexia. The report aims to provide the whole treatment progress and lessons learned from this case, which is relatively rare.

Unusual Urologic Metastasis From Gastrointestinal Cancers: A Compilation of Case Reports and Literature Review

Gastrointestinal cancers are highly prevalent around the world. In the metastatic setting, the most usual sites for metastases are the liver, lymph nodes, peritoneum, and lung. Urologic metastases are very rare. We report a case series of three patients with gastrointestinal tumours in different topographies (stomach, colon, and rectum) with urological metastases. In all cases, the patients were initially treated with curative intent. Two of the patients presented with bladder metastases, and the third had penile metastases in addition to pulmonary metastases. Haematuria was the most common symptom at presentation. One of the patients had a good overall survival and is still undergoing palliative intent chemotherapy. In the literature, there are few reported cases of urological metastases from gastrointestinal cancers, and that is the aim of this publication.

Metastatic melanoma concurrent to the urinary bladder and endometrium: Case report

We report a case of a 47-year-old woman with a history of acral lentiginous melanoma, left great toe subungual primary, metastatic to the lungs, brain, and spleen, presenting with lower urinary tract symptoms. She had also palpated and removed a dark mass from her vaginal canal. Magnetic resonance imaging (MRI) showed polypoidal lesions within the urinary bladder and the endometrium. The suspected differential diagnosis was endometrial and bladder melanoma metastases, based on her cancer history and MRI findings. The patient underwent cystoscopy with transurethral resection of the bladder tumor and endometrial biopsy, and pathology was consistent with metastatic melanoma. Bladder and endometrial metastatic lesions are exceedingly rare. Herein, we describe an unusual case of metastatic melanoma concurrent to the urinary bladder and endometrium.

Pancreatic cancer diagnosed by the detection of gross hematuria due to urinary bladder metastasis: A case report

Pancreatic cancer is not easy to detect at its early stages due to difficulties in identifying symptoms at these stages. As it progresses, abdominal pain, loss of appetite, abdominal distension, jaundice and pain in the back, especially the lower back, might develop. Moreover, sudden onset or worsening of diabetes mellitus may be seen, which often prompts screening for the detection of pancreatic cancer. Since it rapidly spreads to surrounding tissues and organs, pancreatic cancer has a poor prognosis. However, metastasis to the bladder is rare, with few cases diagnosed on the basis of detecting gross hematuria. The current study presents a case of gross hematuria and exacerbated diabetes in a 90-year-old woman. Cystoscopy revealed a non-papillary tumor in the posterior bladder wall. Pathological examination of bladder tumor specimens obtained via transurethral resection revealed adenocarcinoma. Subsequent systemic examinations revealed primary pancreatic cancer that had metastasized to the bladder. To the best of our knowledge, this is the second reported case of pancreatic cancer diagnosed based on the detection of gross hematuria due to bladder metastasis, since 1992.

Unusual metastasis from renal cell cancer after partial nephrectomy and sequential targeted therapy

INTRODUCTION

Metastatic renal cell carcinoma is treated with various regimens. As their outcomes are improving and follow-up periods are growing longer, the rate of unusual visceral metastases may increase.

CASE PRESENTATION

A 68-year-old man diagnosed with lung, pancreatic, and renal metastases 9 years after left partial nephrectomy and a diagnosis of pT1a clear cell renal cell carcinoma started molecular targeted therapy using sunitinib. Nine years after the initiation of targeted therapy, a mass lesion in the esophagus was revealed by follow-up computed tomography, and endoscopic mucosal resection of the esophageal metastatic lesion was performed. One year later, a bladder tumor was detected by follow-up computed tomography. The patient underwent transurethral resection of the bladder tumor. Histological evaluation of both resected specimens disclosed clear cell renal cell carcinoma.

CONCLUSION

We present a valuable case of metachronous esophagus and bladder metastases from renal cell carcinoma in a long-term follow-up.

Hormone Receptor Positive/HER2 Negative Breast Cancer With Isolated Bladder Metastasis: A Rare Case

Breast cancer is the most common cancer diagnosed in women in North America. Hormone receptor positive (HR+) and HER2 negative (HER2-) breast cancers account for at least 60% to 70% of all breast cancer cases. They usually metastasize to lymph nodes, bones, liver, lungs, and brain. Urinary bladder is a very unusual site for metastatic HR+/HER2- breast cancer and occurs in only 2% of all metastatic disease. In this article, we present a case of a 63-year-old female with locally advanced breast cancer who underwent mastectomy, adjuvant chemotherapy, radiation, and hormonal therapy. She was in remission for almost 17 years and subsequently presented with hematuria and lower abdominal pain. Cystoscopy was performed, which showed evidence of bladder wall thickening. Histopathology showed metastatic HR+/HER2- breast cancer consistent with her history of breast primary. Imaging studies did not show any other evidence of metastatic disease. She was started on cyclin D kinase 4/6 inhibitor, palbociclib, in combination with an aromatase inhibitor, letrozole. This is an exceedingly rare case of HR+ and HER2- breast cancer with metastasis to the urinary bladder. The late onset of recurrence with bladder metastasis makes this case very unique and to our knowledge only few similar cases have been reported in the literature.

Unusual Case of Pancreatic Adenocarcinoma with Bladder Metastasis

Background: The pancreas can be the site of neoplasms of several histogenetic origins; in most cases, tumors derive from the exocrine component, and ductal adenocarcinoma certainly prevails over the others. This tumor displays remarkably aggressive behavior, and it is often diagnosed at a late stage of disease. Case presentation: We discuss the rare case of a 76-year-old male with locally advanced pancreatic head adenocarcinoma who developed uncommon metastatic disease. The bladder constitutes a very rare site of metastases, mostly deriving from melanoma, gastric, lung and breast cancers. The bladder's secondary involvement in pancreatic malignancies represents an extremely unusual occurrence, and there are very few cases described in the literature to date. Conclusions: The finding of pancreatic adenocarcinoma metastases leads to a poor prognosis, and patients who are diagnosed at this stage constitute 53% of cases, with a 5-year survival of 3%. Although rare, therefore, the diagnostic hypothesis of pancreatic ductal adenocarcinoma (DAC) metastases to the bladder must, in some cases, be considered, especially if accompanied by a clinical picture that may suggest it.

Bladder Metastasis from Breast Cancer: A Systematic Review

Breast cancer is the leading cause of cancer death in women, and most breast cancer related deaths are due to metastasis. Urinary bladder metastasis from breast cancer is rarely reported in the literature. In this review, we examined the reported cases of breast cancer metastasizing to the urinary bladder, with the objective of identifying clues that could help physicians in diagnosing and planning further treatment. We performed a systematic review of the literature to analyze the clinical and pathological profile of this disease. We thoroughly examined and systematically reported data regarding epidemiology, the pattern of spread, signs and symptoms, pathology and hormonal status, diagnostic workup, management, and outcomes. Urinary bladder metastases from breast cancers are more common in invasive lobular carcinoma. In addition to asymptomatic presentations, most cases present with hematuria and voiding dysfunction. This review summarizes the insights into the incidence, clinical presentation, diagnostic workup, management, and prognosis of urinary bladder metastasis in patients with breast cancer.

Longitudinal monitoring of cerebrospinal fluid-derived circulating tumor cells: a pilot study

Breast cancer-associated leptomeningeal metastasis (LM) is a particularly aggressive syndrome with an abysmal prognosis. Here we applied the SE-i•FISH platform for surveillance and function analysis of cerebrospinal fluid-derived circulating tumor cells (CSFTCs) from five breast cancer patients with LM. We observed a negative correlation of CK18 expression on CSFTCs with clinical symptom remission, and confirmed that at least six intrathecal chemotherapies were necessary. We also present the case of a breast cancer patient with bladder and leptomeningeal metastasis. The bladder is an extremely unusual site for metastasis from primary breast cancer, with only 14 cases sporadically reported worldwide. Our platform could help monitor CSFTC numbers and treatment responses for patients with LM.

Urinary bladder metastasis from lung adenocarcinoma: A rare cause of hematuria

We presented an unusual case of hematuria caused by a solitary bladder metastasis from lung adenocarcinoma. A confident diagnosis of secondary adenocarcinoma of the bladder was made by clinical suspicion based on patient's past history, careful examination of tumor morphology, and a directed panel (cytokeratin [CK] 7/CK20/thyroid transcription factor 1) of immunohistochemistry. We sought, through sharing our experience in the investigative and diagnostic process, to contribute to the better understanding of this unusual cause of hematuria.

A rare case of synchronous renal cell carcinoma of the bladder presenting with gross hematuria

A 57-year old man was referred to the Urology Department due to gross hematuria; abdominal ultrasound revealed an unspecific solid tumor of the left bladder wall. Ultrasound, transurethral resection of the bladder mass with subsequent histological analysis, thoracic and abdominal computed tomography-scan and brain magnetic resonance imaging were performed. He was diagnosed with a bladder metastasis of clear cell renal cell carcinoma (RCC) with concomitant bone, pulmonary, and cerebral metastatic disease of a primary RCC of the right kidney.

MANAGEMENT

Transurethral resection of the bladder mass, cerebral and bone radiotherapy, removal of the primary tumor, targeted systemic therapy with mTOR followed by tyrosine kinase inhibition.