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Query: UMLS:C0005684 (bladder cancer)
 16,431 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The feasibility of high precision radiotherapy to the bladder region is limited by bladder motion and volume changes. In the near future, we plan to begin treatment delivery of bladder cancer patients with the acquisition of a cone beam CT image on which the complete bladder will be semi-automatically localized. Subsequently, a bladder shape model that was developed in a previous study will be used for bladder localization and for the prediction of shape changes in the time interval between acquisition and beam delivery. For such predictions, knowledge about urinary inflow rate is required. Therefore, a series of MR images was acquired over 1 h with time intervals of 10 min for 18 healthy volunteers. To gain insight in the reproducibility of the bladder shape over longer periods of time, two additional MRI series were recorded for 10 of the volunteers. To a good approximation, the bladder volume increased linearly in time for all individuals. Despite receiving drinking instructions, we found a large variation in the inflow rate between individuals, ranging from 2.1 to 15 cc/min (mean value: 9 +/- 3 cc/min). In contrast, the intravolunteer variation was much smaller, with a mean standard deviation (SD) of 0.4 cc/min. The inflow rate was linearly correlated with age (negative slope). To study the reproducibility of the bladder shape, we compared bladder shapes of equal volume. For all individuals, the caudal part of the bladder was the most reproducible (variations<0.3 cm in all cases). The cranial and posterior parts of the bladder was much less reproducible, with local SD values up to approximately 1.2 cm for bladders with a volume of 200 cc. These large long-term variations were primarily caused by changes in position and filling of the small bowel and rectum. However, for short time intervals, the rectal filling was (nearly) constant. Therefore, the reproducibility of urinary inflow, combined with the previously developed shape model gives us an excellent tool to predict short-term shape changes. We intend to use this tool for further improvement of image-guided radiotherapy for bladder cancer patients.
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PMID:Reproducibility of the bladder shape and bladder shape changes during filling. 1619 89

A 72-year-old man had undergone trasucethral resection of bladder tumor (TUR-Bt) three times from 1990 to 1991 and he had been lost to follow with no recurrence from 1996, came to our hospital complaining of asymptomatic macrohematuria in May 1999. A bladder tumor existed around the right ureteral orifice with right hydronephrosis. MRI and TUR-Bt revealed that the cancer was transitional cell carcinoma (TCC) > small cell carcinoma, G3, pT3b. Because the patient insisted on bladder preservation, intra arterial chemotherapy with cisplatinum (CDDP) and epirubicin (EPI-adr) followed by radiotherapy with CDDP was performed. The treatment resulted in a clinical complete response (CR), and the bladder was preserved. In January 2004, an invasive bladder cancer recurred at the left lateral wall. This time, neoadjuvant intra-arterial chemotherapy with CDDP and EPI-adr, followed by radical cystectomy was performed. Histologically, the recurrent bladder cancer was TCC, G3, pT3b.
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PMID:[Invasive bladder cancer recurrenced 5 years after complete response status by chemotherapy and radiotherapy: a case report]. 1636 9

Blindness is an unusual symptom in the clinical course of cancer. When it appears it is necessary to differentiate between benign and malign causes. Brain metastases in bladder cancer are extremely rare. MRI is the best diagnostic option. We present a deaf-and-dumb male with subacute blindness, 12 months after the diagnosis of a metastatic bladder cancer. Computerised tomography scan and MRI revealed a mass into the pituitary gland and sella, probably of metastatic origin.
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PMID:Blindness in a bladder cancer patient. 1732 24

In summary, imaging now has an important role in the evaluation of patients with invasive bladder cancer. It is useful in staging of bladder cancer, despite having some limitations. CT is widely accessible and has enjoyed rapid advances in multidetector technology which have far-reaching applications. MRI, due to its intrinsic tissue characterization, is reported to have a higher accuracy for staging bladder cancer. It is superior to CT in determining the depth of bladder wall invasion. CT, as well as traditional MRI, rely on morphological criteria and are both useful in the detection of metastases to the lymph nodes, liver and bone. MRI, however, can now also take advantage of the tremendous advance in lymph node evaluation brought about by the advent of USPIO nodal imaging. MRI is also considered superior in follow-up of patients with bladder cancer post-therapy as it can distinguish biopsy changes more accurately than CT. In conclusion, it is clear that imaging plays a growing and increasingly important role in the evaluation of patients with bladder cancer.
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PMID:Imaging of urinary tract tumors. 1861 23

Rectal linitis plastica (RLP) is a circumferentially infiltrating intramural anaplastic carcinoma that results in a rigid constricted rectum with thickened walls. A long delay between the onset of symptoms and the diagnosis often occurs because RLP can mimic a lot of diseases and endoscopy and biopsies are often negative, owing to the fact that the mucosa is frequently unaffected in RLP. RLP secondary to bladder cancer is rarely described in the English literature. We present the first report of the MR features of secondary rectal linitis plastica from a bladder carcinoma. Two patients presented with changed bowel habits. All diagnostic tests were inconclusive. In both patients, pelvic T(2) weighted MR images revealed a double-layered thickening of the rectal wall with an inner isointense circumferential thickening of the submucosa and outer hypointense circumferential thickening of the muscular rectal wall. Based on MRI, further investigations were performed and secondary RLP was diagnosed. It is important to establish the diagnosis of RLP early because of its bad prognosis. The value of MRI in supporting the diagnosis of RLP should not be underestimated. As endoscopy plus biopsy can often be negative, we suggest that, if pelvic MRI shows a concentric double layered thickening of the rectal wall over a long segment, then the diagnosis of RLP should be considered. This should prompt further investigations either to confirm or rule out the diagnosis of RLP by performing endoscopy with deep rectal wall biopsies.
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PMID:Linitis plastica of the rectum secondary to bladder carcinoma: a report of two cases and its MR features. 1879 53

We report a rare case of plasmacytoid urothelial carcinoma (PUC) of the urinary bladder. A 50-year-old man complained of pollakiuria and urinary incontinence. MRI detected a bladder tumor invading the rectum and bilateral hydroureteronephrosis. Radical cystectomy with partial resection of the rectum was performed, and ileus due to peritoneal dissemination occurred 2 years after surgery. He died of the disease 42 months after the initial presentation. Histologically, urothelial carcinoma in situ with a focal invasive urothelial carcinoma (IUC) component and widely spread PUC was observed. There was no lymph node metastasis. PUC cells had eccentrically placed nuclei and eosinophilic cytoplasm resembling plasmacytoma cells, and proliferated with a single-cell infiltrative pattern to the outside of the bladder. IUC cells with intracytoplasmic lumina were focally intermingled with PUC cells. Immunohistochemically, PUC cells were positive for cytokeratin 7, epithelial membrane antigen, and CA19-9, but negative for cytokeratin 20, E-cadherin, p63, and lymphoid markers. The Ki-67 labeling index of PUC cells was 9.3%. IUC containing intracytoplasmic lumina showed intermediate features of conventional IUC and PUC morphologically and immunohistochemically. PUC is a distinct entity of bladder cancer with a high propensity for invasion and poor prognosis.
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PMID:Plasmacytoid urothelial carcinoma of the urinary bladder: a case report and immunohistochemical study. 1904 Nov 93

Diffusion-weighted MRI (DW-MRI) is a functional imaging to assess molecular diffusion. We report a case in which treatment response to lymph node metastatic bladder cancer was monitored by DW-MRI. A 67-year-old man had paraaortic lymph node metastasis from bladder cancer; the paraaortic lymph node showed high signal intensity on DW-MRI. After four course treatment of gemcitabine and cisplatin, the lesion showed reduction of signal intensity on DW-MRI and increase of the apparent diffusion coefficient value. These signal changes were consistent with the change of morphological images (CT, MRI (T1-W, T2-W)), 18F-FDG PET and tumor markers. This case suggests that DW-MRI is useful in monitoring treatment response of metastatic bladder cancer.
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PMID:[Use of diffusion-weighted MRI in monitoring response of lymph node metastatic bladder cancer treated with chemotherary]. 1906 91

Tuberculomas are common forms of central nervous system tuberculosis, presenting as space-occupying-lesions. Brainstem tuberculomas are rare among all intracranial tuberculomas. In old patients, in the absence of tuberculosis history, diagnosis may be challenging. In this case, we present a 70-year-old patient, with bladder cancer, without known tuberculosis who presented with stroke-like symptoms, clinically. Diffusion-weighted imaging revealed no finding of stroke, however, a medulla oblongata tuberculoma, mimicking metastasis was evident on MRI.
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PMID:Medulla oblongata tuberculoma mimicking metastasis presenting with stroke-like symptoms. 1949 58

Cyclophosphamide (Cy) is an alkylating agent used over the past 40 years to halt rapidly progressive forms of multiple sclerosis (MS). High doses of Cy produce marked immunosuppression and an anti-inflammatory immune deviation. Cy is most effective in young patients, with very active MS (frequent relapses, rapid accumulation of disability, and gad+ lesions on brain MRI). Monthly intravenous pulses of Cy for 1 year, followed by bimonthly pulses for the second year are a well-tolerated protocol in MS. Most side effects (mild alopecia, nausea and vomiting, and cystitis) are transient, dose dependent, and reversible. Permanent amenorrhoea and bladder cancer have rarely been described. As second-line therapy, Cy can be used in non-responders to IFN-beta or glatiramer acetate. As induction therapy, a short course (6-12 months) of Cy can precede immunomodulatory drugs in selected patients with an aggressive MS onset.
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PMID:Cyclophosphamide as second-line therapy in multiple sclerosis: benefits and risks. 1988 69

Angiogenesis is a key process in the growth and metastasis of cancer, and genitourinary tumors are no exception. The evolution of angiogenesis as an important target for novel anticancer therapeutics has brought with it new challenges for in vivo imaging. Most imaging techniques quantify physiological parameters, such as blood volume and capillary endothelial permeability. Although CT, PET and ultrasonography have shown promise, MRI is the most common method used to evaluate angiogenesis in clinical trials of genitourinary tumors. Pilot studies of MRI, CT and ultrasonography in patients with renal cancer have produced promising results; reductions in vascular permeability and blood flow have been correlated with progression-free survival. The vascular characteristics of prostate cancer have been evaluated by MRI, and this has been suggested as a means of assessing tumor response to hormone deprivation therapy. Current evidence highlights the potential of angiogenesis imaging in the diagnosis, staging and possibly response monitoring of bladder cancer. In the future, assessment of the angiogenic process at the structural, functional and molecular levels, before, during and after antiangiogenic therapy will undoubtedly be integrated into wider clinical practice.
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PMID:Imaging angiogenesis of genitourinary tumors. 2008 77


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