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Presentation and management of a patient with subcutaneous metastatic transitional cell carcinoma of the bladder

Nature Clinical Practice Urology volume 5, pages 691–694 (2008)Cite this article

Abstract

Background A 60-year-old female with a 6-month history of muscle-invasive transitional cell carcinoma of the bladder presented with an enlarging subcutaneous lesion involving her right flank. She had previously undergone radical cystectomy, bilateral pelvic lymphadenectomy and ileal orthotopic neobladder reconstruction.

Investigations Axial fused fluorodeoxyglucose PET–CT of the chest, abdomen and pelvis, fine needle aspiration with direct ultrasound guidance, excisional biopsy and immunohistochemistry.

Diagnosis Subcutaneous and liver metastases of transitional cell carcinoma.

Management Wide local excision of the subcutaneous lesion followed by combination gemcitabine–cisplatin chemotherapy. Gemcitabine was administered at a dose of 1,000 mg/m2 on days 1, 8, and 15, and cisplatin was administered at a dose of 75 mg/m2 on day 1; the schedule was repeated every 28 days for three cycles.

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Figure 1: Fused fluorodeoxyglucose PET–CT scan.
Figure 2: Photomicrograph of the subcutaneous lesion.

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Authors and Affiliations

  1. HH Alphs is a Urology Resident at Northwestern University, Chicago, IL.,

    Hannah H Alphs

  2. and MP Schoenberg is a Professor of Urologic Oncology and Director of the Division of Urologic Oncology at the Brady Urological Institute, J Miles-Thomas and TJ Bivalacqua are Urology Residents at the Johns Hopkins Hospital, F Attenello is a Medical Student at Johns Hopkins School of Medicine, JM Taube is a Pathology Resident at Johns Hopkins Hospital, TJ Guzzo is a Urologic Oncology Fellow at Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Baltimore, MD, USA.,

    Jennifer Miles-Thomas, Frank Attenello, Janis M Taube, Thomas J Guzzo, Mark P Schoenberg & Trinity J Bivalacqua

  3. G Fonseca is a Medical Oncologist in private practice in Lecanto, FL, USA.,

    Gustavo Fonseca

Authors
  1. Hannah H Alphs
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  2. Jennifer Miles-Thomas
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  3. Frank Attenello
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  4. Janis M Taube
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  6. Thomas J Guzzo
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  8. Trinity J Bivalacqua
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Corresponding author

Correspondence to Trinity J Bivalacqua.

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The authors declare no competing financial interests.

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Alphs, H., Miles-Thomas, J., Attenello, F. et al. Presentation and management of a patient with subcutaneous metastatic transitional cell carcinoma of the bladder. Nat Rev Urol 5, 691–694 (2008). https://doi.org/10.1038/ncpuro1253

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