T4 urothelial carcinoma in undiagnosed closed bladder exstrophy in a post-menopausal female

It is rare to see an adult presenting with exstrophy of the bladder. Malignant conversion in exstrophy occurs in 4%, with adenocarcinoma as the most common histopathology. We report the first case of metastatic high grade urothelial carcinoma with squamous and sarcomatoid differentiation arising fro...

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Bibliographic Details
Published inCanadian journal of urology Vol. 25; no. 1; p. 9214
Main Authors McArdle, Brian J, Vidal, Patricia, Psutka, Sarah P, Hollowell, Courtney M P
Format Journal Article
LanguageEnglish
Published Canada 01.02.2018
Subjects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Bladder Exstrophy - diagnostic imaging
Bladder Exstrophy - pathology
Carcinoma, Transitional Cell - diagnostic imaging
Carcinoma, Transitional Cell - drug therapy
Carcinoma, Transitional Cell - pathology
Conservative Treatment
Contrast Media
Cystoscopy - methods
Disease Progression
Fatal Outcome
Female
Humans
Middle Aged
Neoadjuvant Therapy - methods
Neoplasm Invasiveness - pathology
Neoplasm Staging
Radiotherapy, Adjuvant
Risk Assessment
Tomography, X-Ray Computed - methods
Urinary Bladder Neoplasms - pathology
Urinary Bladder Neoplasms - therapy
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Summary:It is rare to see an adult presenting with exstrophy of the bladder. Malignant conversion in exstrophy occurs in 4%, with adenocarcinoma as the most common histopathology. We report the first case of metastatic high grade urothelial carcinoma with squamous and sarcomatoid differentiation arising from undiagnosed, closed bladder exstrophy in a female at advanced age with associated bilateral deep vein thrombosis and clot retention. The patient developed clinical progression of disease despite neoadjuvant gemcitabine-cisplatin and salvage (or palliative) radiotherapy. To the best of our knowledge, this is the first reported case of a primary urothelial malignancy in occult bladder exstrophy.
ISSN:1195-9479