BCG Induced Necrosis of the Entire Bladder Urothelium

Malte Krönig; Cordula Jilg; Dieter Burger; Mathias Langer; Sylvia Timme-Bronsert; Martin Werner; Ulrich Wetterauer; Wolfgang-Schultze Seemann

doi:10.1016/j.eucr.2015.06.002

BCG Induced Necrosis of the Entire Bladder Urothelium

Urol Case Rep. 2015 Jun 21;3(5):161-3. doi: 10.1016/j.eucr.2015.06.002. eCollection 2015 Sep.

Authors

Malte Krönig¹, Cordula Jilg¹, Dieter Burger², Mathias Langer², Sylvia Timme-Bronsert³, Martin Werner³, Ulrich Wetterauer¹, Wolfgang-Schultze Seemann¹

Affiliations

¹ Medical Centre, University of Freiburg, Department of Urology, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany.
² Medical Centre, University of Freiburg, Department of Radiology, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany.
³ Medical Centre, University of Freiburg, Department of Pathology, Breisacher Strasse 155a, 79106 Freiburg im Breisgau, Germany.

Abstract

Instillation therapy with attenuated tuberculosis bacteria (BCG) can significantly reduce rates of recurrence of non-muscle invasive bladder cancer. Local and systemic side effects such as dysuria, irritative voiding symptoms or partial bladder contracture and systemic inflammation were reported. A 75 year-old male patient with recurrent non muscle invasive bladder cancer developed necrosis of the entire bladder urothelium more than six years after BCG instillation immunotherapy. The resulting irritative voiding symptoms and low bladder capacity required radical cystectomy. BCG instillation can cause severe side effects, which develop gradually and eventually need radical surgical therapy such as cystectomy without tumor recurrence.

Keywords: BCG; BCG, Bacille Calmette Guerin; Bladder cancer; Cystectomy; MIBC, muscle invasive bladder cancer; NMIBC, non muscle invasive bladder cancer; Urothelial necrosis.

Publication types

Case Reports