Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metastatic involement of penis is an exceptionally rare condition. 77% of the metastases are originated from the pelvic region; prostate and bladder are the most frequent primary locations. Retrograde venous route, retrograde lymphatic route, arterial spread, direct extension, implantation and secondary to instrumentation are the mechanisms of metastasis. Approximately two thirds of all penile metastasis are detected at a mean time of 18 months after the detection of the primary tumor and the remaining one third is presented at the same time with primary tumor. Diagnosis is usually made by biopsy and also non invasive methods as MRI or colour-coded duplex ultrasonography. Treatment options in these patients are local excision, partial or complete penectomy, external beam radiation therapy and chemotheraphy. Despite these alternatives prognosis is usually poor.We present a case of urethelial carcinoma of the bladder and coincidental prostate adenocarcinoma with penile metastasis which is presented with priapism 6 months after radical cystectomy as the first systemic manifestation. We performed biopsy initially for staging and the patient underwent MRI showing the extension of the disease. The patient underwent radiotherapy of 56 gy and priapism partially resolved after the treatment. Chemotheraphy was also planned but the patient died 3 months following radiotheraphy.
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PMID:Early penile metastasis from primary bladder cancer as the first systemic manifestation: a case report. 2018 86

Clear cell transitional carcinoma of the bladder is a subtype of transitional carcinoma that morphologically resembles a clear cell renal cell carcinoma. Although kidney tumors do not frequently metastasize to the bladder, the recurrence after a clear cell renal cell carcinoma has been reported even several years after nephrectomy. We report the case of a male patient to whom radical nephrectomy for a clear cell renal cell carcinoma has been done, with a bladder tumor featuring polygonal cells with abundant clear cytoplasm deeply infiltrating the vesical wall. We discuss the morphologic features, the immunohistochemical staining with a new marker and the UroVysion FISH analysis to achieve a definitive diagnosis.
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PMID:Clear cell carcinoma of the bladder in a patient with a earlier clear cell renal cell carcinoma: a case report with morphologic, immunohistochemical, and cytogenetical analysis. 2021 3

Small-cell carcinoma of the urinary bladder is an extremely uncommon form of urologic malignancy, accounting for less that 1% of new cases of bladder cancer. It is an aggressive malignancy which, like its pulmonary counterpart, tends to spread with distant metastases. This malignancy is generally chemotherapy and radiotherapy sensitive. Metastatic disease is typically treated with regimens active against small-cell carcinoma of the lung, such as cisplatin and etoposide. There are no data regarding second-line treatment of this cancer. We report our experience in 3 patients using the second generation vinca alkaloid, vinorelbine, in refractory metastatic small-cell carcinoma of the bladder. These 3 patients had extensive prior therapy but all 3 responded to weekly vinorelbine, with a complete response (CR) in 1, near CR in the second, and partial response in the third. Of note, the patient who sustained a CR has remained without disease and with excellent quality of life for nearly 4 years since starting vinorelbine. Indeed, the therapy was very well tolerated in all 3 patients with grade 2 cytopenia being the only toxicity. We conclude that vinorelbine is well tolerated and has activity in this case series in the second-line treatment of metastatic small-cell carcinoma of the bladder.
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PMID:Significant activity of single agent vinorelbine against small-cell cancer of the bladder as second line chemotherapy: a case series and review of the literature. 2036 63

Urothelial carcinoma of the bladder with prostatic stromal invasion is included in stage pT4a of the new 2010 American Joint Committee on Cancer/Tumor-Node-Metastasis classification. Despite being a strong indicator of poor prognosis, there have been few large studies investigating the impact of extent of prostatic stromal invasion on patient outcome. A search of the surgical pathology and expert consultation files at our institution was made for cystoprostatectomy specimens diagnosed as urothelial carcinoma with prostatic stromal invasion from 2002 to 2009. Cases were further stratified as follows: group 1--focal prostatic stromal invasion and group 2--extensive prostatic stromal invasion. Only patients who had surgery as monotherapy and those with available follow-up information were selected for this study. Thirty-five cases of urothelial carcinoma with prostatic stromal invasion and follow-up information were identified. Mean patient age was 70 years (range, 44-88 years). Of these 35 patients, 15 (43%) had focal prostatic stromal invasion and 20 (57%) had extensive prostatic stromal invasion. Angiolymphatic invasion was identified in 93% of group 1 cases and 79% of group 2 cases. Positive margins were identified in 50% of group 1 cases and 45% of group 2 cases. Incidence of nodal metastasis was 64% for group 1 and 60% for group 2. Four (27%) of 15 cases in group 1 and 6 (30%) of 20 cases in group 2 had various histologic variants identified. In group 1, there were 2 cases of urothelial carcinoma with micropapillary features and urothelial carcinoma with focal squamous differentiation. In group 2, there were 3 cases of urothelial carcinoma with focal squamous differentiation, 2 cases of urothelial carcinoma with focal sarcomatoid differentiation, and 1 case of urothelial carcinoma with focal micropapillary features. One- and 3-year overall survival for group 1 was 53% and 27%, respectively. One- and 3-year overall survival for group 2 was 47% and 12%, respectively. Mean survival was 17.4 and 16.3 months for groups 1 and 2, respectively. Overall survival curves did not show a statistically significant difference between the 2 groups from initial diagnosis (P = .889) and radical cystoprostatectomy (P = .369). Our study suggests that extent of prostatic stromal invasion by urothelial carcinoma of the bladder as an independent factor does not impact overall patient survival. Other well-known prognostic factors including positive margin status, presence of aggressive histologic variants of urothelial carcinoma, angiolymphatic invasion, and distant metastasis likely play more critical roles in predicting outcome in male patients who have urothelial carcinoma with prostatic stromal invasion.
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PMID:Urothelial carcinoma of the bladder with transmural and direct prostatic stromal invasion: does extent of stromal invasion significantly impact patient outcome? 2087 Feb 65

Robotic technology may be a promising tool in reduction of morbidity in radical anterior pelvic exenteration for invasive bladder cancer. We report our initial experience with robotic-assisted radical anterior pelvic exenteration in females in an attempt to evaluate the technique's feasibility and outcomes. A retrospective review of our bladder cancer database was performed. Twelve women that underwent robotic-assisted radical anterior pelvic exenteration, bilateral pelvic lymphadenectomy, and urinary diversion for clinically localized urothelial carcinoma of the bladder between 2004 and 2008 were included in this retrospective study. Median age was 73.0 +/- 9.6 years and median body mass index (BMI) was 23.5 +/- 5.0 kg/m2. Ten patients underwent ileal conduit diversion, one had an orthotopic neobladder and one an Indiana pouch. Median total operating time was 6.4 +/- 1.5 hours with median console and diversion times of 4.7 +/- 0.9 and 2.5 +/- 1.5 hours respectively. Median blood loss was 275.0 +/- 165.8 ml. Median length of stay was 8.0 +/- 1.6 days. Four patients were T2N0 or less, five T3N0, one T3N1 and two patients T4N0. There was one patient with positive surgical margins. Median number of lymph nodes removed was 23.0 +/- 11.4. Median follow-up of 9.0 +/- 6.0 months was available for ten patients. One had a recurrent ureteroenteric stricture, one had colpocleisis for vault prolapse, and three had metastatic disease. Robotic-assisted laparoscopic anterior pelvic exenteration appears to be a favorable surgical option with acceptable operative, pathological, and short-term clinical outcomes. According to the UCI experience, robotic anterior exenteration appears to achieve the clinical and oncologic goals for the surgical treatment of bladder cancer.
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PMID:Robotic radical anterior pelvic exenteration: the UCI experience. 2114 32

In 2004, the WHO recognized the plasmacytoid subtype as a distinct variant of vesical malignancy. We present a case of plasmacytoid urothelial carcinoma of the bladder treated with radical surgery and adjuvant chemotherapy, thus achieving long-term survival. A 70-year-old woman presented with persistent dysuria and underwent cystoscopy which revealed the presence of diffuse deformity, involving the right lateral vesical wall. Histology revealed the presence of muscle-invasive urothelial carcinoma of the plasmacytoid variant. The patient subsequently underwent radical cystectomy and orthotopic ileal neobladder substitution, as well as adjuvant chemotherapy. At 36 months of follow-up, the patient is free of local recurrence and metastases, while her voiding function is well preserved. Bladder plasmacytoid urothelial carcinoma is considered a rare tumor, with unique microscopic and immunohistochemical features. The ideal therapeutic approach is debatable, but the combination of radical surgery and chemotherapy should constitute the mainstay of management.
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PMID:Plasmacytoid urothelial carcinoma of the bladder: a rare malignancy. 2132 83

The standard of care for transitional-cell carcinoma of the bladder with invasion to the muscularis propria is radical cystectomy with bilateral pelvic lymph node dissection. However, currently there is a tendency for organ preservation in selected cases of muscle-invasive bladder cancer. Trimodality treatment, including transurethral resection of the bladder tumor (TURBT), radiation therapy and chemotherapy, has been shown to produce 5-year and 10-year overall survival rates comparable to those of radical cystectomy. The current 5-year overall survival rates range from 50 to 67% with trimodality treatment, and approximately 75% of the surviving patients maintains their bladder. After trimodality treatment complete response is obtained in more than 70% of patients with muscle-invasive bladder cancer. Clinical criteria helpful in determining patients for bladder preservation include such variables as small tumor size (<2 cm), early tumor stage (T2-T3 disease), a visibly and microscopically complete TURBT, absence of ureteral obstruction, no evidence of pelvic lymph node metastases, and absence of carcinoma in situ (Tis). The close collaboration of urologists, radiation oncologists and medical oncologists is of paramount importance in succeeding in bladder preservation.
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PMID:Selective organ preservation in muscle-invasive bladder cancer: review of the literature. 2208 98

Urothelial carcinoma is the fifth most common malignancy diagnosed each year in the United States. Neoadjuvant and adjuvant chemotherapy are given to decrease the risk of recurrent or metastatic disease with the more robust clinical data supporting the former. Bladder preservation utilizes a trimodality approach with maximal transurethral resection followed by concurrent chemotherapy and radiation and is appropriate for select patients. Gemcitabine and cisplatin is the current standard of care for first-line treatment in fit patients with metastatic disease. Optimal second-line therapy remains undefined, and targeted agents are under investigation. Clinical trial participation should be encouraged in patients with urothelial carcinoma of the bladder to help improve treatment regimens and outcomes. Synopsis. Chemotherapy is commonly used in the treatment of urothelial carcinoma of the bladder. This paper will review the role of chemotherapy in the neoadjuvant, adjuvant, bladder sparing, and metastatic settings.
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PMID:Update on chemotherapy in the treatment of urothelial carcinoma. 2212 50

Malignant priapism, or priapism secondary to locally invasive or metastatic cancer, is a rarely reported phenomenon with a very poor prognosis. We report on a case of malignant priapism secondary to metastasis of urothelial carcinoma of the bladder in a 73 year old gentleman who underwent a radical cystectomy with negative margins but positive nodal disease three months prior to presentation. The rapid progression of disease and resultant demise of this patient is unusual even when compared to the limited available literature. Rapid progression to muscle invasion despite intravesical immunotherapy, histologic involvement of the prostate and seminal vesicles with extensive lymphovascular invasion, and the rapid development of metastasis are all consistent with the aggressive nature of a cancer that has metastasized to the penis. Further, while conservative penile sparing therapy may be a goal in patients with limited life expectancy, ongoing pain and infectious concerns may force the physician to resort to a penectomy.
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PMID:Case of malignant priapism and review of the literature. 2243 56

Bladder Cancer (BCa) is the most common malignancy arising from the urinary tract. One of the mainstays of diagnosis, staging, and therapeutic decision-making for BCa is accurate and appropriate imaging. The ability to identify metastatic disease preoperatively is of utmost importance in determining treatment. Advances in standard cross sectional imaging techniques like Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) have improved imaging of bladder cancer. Over the last decade, 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) in combination with CT (18F-FDG PET/CT) has become an important non-invasive imaging modality for the preoperative staging of various malignancies. 18F-FDG PET/CT is useful for detection of metastatic disease in BCa, but the ability to detect primary bladder wall lesions remains to be elucidated. To overcome the problem with urinary excretion of 18F-FDG, new PET tracers are being tested. MRI is an accurate technique for the local staging of BCa due to its superior spatial and contrast resolution. Anatomical MRI has a modest utility in NM-staging of BCa. However, incorporation of functional MR techniques, such as diffusion weighted MRI can improve the results for lesion detection and staging and multi-parametric MRI`s role is yet to be explored widely. The aim of this review is to present the recent advances in PET/CT and MRI in BCa, with particular focus on improvements in staging.
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PMID:PET/CT and MRI in Bladder Cancer. 2347 Nov 67


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