Isolated cerebellar metastasis from urothelial carcinoma: A case report of a rare phenomenon

• Published in: Brain & spine Vol. 3; p. 102716
• Main Authors: Verheijen, Eduard J.A., Taal, Walter, Tewari, Rishi D.S. Nandoe, Giessen, Mariëtte C.A., Roshani, Hossain
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 2023; Elsevier
• Subjects: Central nervous system; Isolated cerebellar metastasis; Radiotherapy; Tumor resection; Urothelial carcinoma; Tumor resection; Isolated cerebellar metastasis; Urothelial carcinoma; Radiotherapy; Central nervous system
• ISSN: 2772-5294; 2772-5294
• DOI: 10.1016/j.bas.2023.102716

Although urothelial carcinoma (UC) generally is non-invasive, contrastingly in 25% of patients UC metastasizes. Isolated central nervous system (CNS) metastasis from UC without other distant metastases are considered rare. In this report we describe a patient with an isolated and solitary cerebellar metastasis from UC. In this case report we explore the value of histological analysis of CNS metastases, imaging, treatment options and survival. A rare case is presented of a patient diagnosed with an isolated CNS metastasis originating from UC. Through a systematic review of literature route of dissemination, current imaging and treatment options, and survival are discussed. A 77-year-old male was diagnosed with a pT2N0M0 high-grade UC and treated with transurethral resection and chemoradiation therapy. Several months later, the patient presented with neurological symptoms, and radiological imaging revealed a solitary cerebellar mass. A body CT scan showed no other metastasis. After surgical resection, histology confirmed urothelial origin of the mass, matching his primary UC and the patient received post-operative stereotactic radiotherapy at the surgical site. Recurrence of the cerebellar mass occurred after 6 months for which the patient received re-resection. The patient died 5.5 months after re-resection. Isolated brain metastases without other distant metastases from UC are rare, so histologic confirmation of the brain metastasis is essential, particularly when the time interval between diagnosis of the UC and brain metastasis increases. Early brain CT is not recommended. PET CT may have additional value in detection of other distant metastases from UC. Despite advancements in treatments, prognosis for CNS metastasis from UC remains poor. •Isolated CNS metastases from primary urothelial carcinoma are rare.•Histological confirmation of the metastatic origin is key.•Despite advancements in treatments, prognosis remains poor.