Urothelial carcinoma in an orthotopic neobladder: an unusual pattern of recurrence and metastasis

BMJ Case Rep. 2017 Oct 24:2017:bcr2017221052. doi: 10.1136/bcr-2017-221052.

Abstract

We report a case of a 65-year-old patient with muscle invasive bladder cancer that was treated with neoadjuvant chemotherapy, followed by radical cystoprostatectomy with pelvic lymph node dissection and orthotopic neobladder according to Hautmann. Nine years later, routine follow-up showed local recurrence in the neobladder and metastatic disease of the urothelial carcinoma in the related mesenteric lymph nodes. The entire neobladder specimen was removed including the mesentery of the neobladder. Based on the anatomical lymph drainage of the ileal neobladder, we considered the metastatic disease in the mesentery lymph node as locoregional disease spread. This case shows that such locoregional lymph node metastasis may be amenable to treatment by induction chemotherapy and radical surgery.

Keywords: urological cancer; urological surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology*
  • Lymph Nodes / surgery
  • Male
  • Neoplasms, Second Primary / diagnostic imaging*
  • Neoplasms, Second Primary / therapy
  • Positron Emission Tomography Computed Tomography / methods
  • Urinary Bladder / diagnostic imaging
  • Urinary Bladder / surgery
  • Urinary Bladder Neoplasms / diagnostic imaging*
  • Urinary Bladder Neoplasms / pathology*
  • Urinary Bladder Neoplasms / therapy
  • Urothelium / diagnostic imaging
  • Urothelium / surgery