A CASE OF AGGRESSIVELY GROWING BLADDER CANCER IN PATIENT WITH LONG TERM CYSTOSTOMY DUE TO SPINAL CORD INJURY
| Autor: | Atsushi Fujikawa, Kentarou Muraoka, Mitsuru Kohno, Takeshi Miura, Katsuyuki Tanaka, Takeshi Kishida, Hiroaki Ishida |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Open biopsy Cystostomy Urology medicine.medical_treatment media_common.quotation_subject Retroperitoneal Lymph Node Urination Cystectomy Postoperative Complications Carcinoembryonic antigen medicine Humans Spinal cord injury Spinal Cord Injuries media_common Bladder cancer biology business.industry Carcinoma medicine.disease Urinary Bladder Neoplasms biology.protein business |
| Zdroj: | The Japanese Journal of Urology. 104:612-615 |
| ISSN: | 1884-7110 0021-5287 |
| DOI: | 10.5980/jpnjurol.104.612 |
| Popis: | The patient was a 38-year-old man. A cystostomy catheter had been inserted when he was 23 years of age for neuropathic bladder due to cervical spinal cord injury at 20 years of age. Purulent discharge from around the cystotomy had continued for approximately 4 months. Examination revealed the formation of a subcutaneous tumor around the cystostomy, with elevated carcinoembryonic antigen (CEA) levels (459.4 ng/ml) in the blood. Urothelial carcinoma was detected using open biopsy. It was considered that primary urothelial carcinoma of the bladder had progressed along the cystostomy, and clinical stage 4 cT4N2M0 was diagnosed, with intrapelvic lymph node metastasis evident on imaging. Four courses of gemcitabine-cisplatin chemotherapy were administered; a partial response was obtained, after which cystectomy and ileal conduit formation were performed with the main aim of improving difficulty in urination. However, retroperitoneal lymph node and liver metastases were observed 1 month postoperation with rapid enlargement; the patient died approximately 2 months after the surgery. The CEA level was observed to be 18,998 ng/ml before he died. Here, we have reported this case with a discussion of the literature concerning the association between long-term indwelling catheter in patients with spinal cord injury and the development of bladder cancer. |
| Databáze: | OpenAIRE |
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