Metástasis de carcinoma de células transicionales de vejiga a estoma del conducto ileal. Reporte de caso y revisión de la literatura
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v81i2.621Palabras clave:
Bladder cancer, Metastasis, Ileal conduit stomaResumen
Clinical case presentation: An 80-year-old man was admitted to our emergency department due to fever and a progressively growing mass in the urinary diversion stoma, four months after radical cystectomy for muscle-invasive bladder cancer.
Surgical resection was done, and histopathologic examination revealed high-grade urothelial carcinoma metastasis. After nearly three years of follow-up, no signs of recurrence have been seen.
Relevance: Urothelial cancer at all stages can metastasize to other organs.
Hematogenous metastasis spreads to all organs, most frequently to the lungs, liver, or bone and lymphatic metastasis spreads to regional lymph nodes in the pelvis, or further, to the retroperitoneal lymph nodes. Metastatic bladder cancer in the ileal conduit stoma is unusual. Cancer recurrence after radical cystectomy has been reported in ureteroileal anastomoses.
Clinical implications: Surgical treatment is an option in those patients. Adjuvant radiotherapy and/or chemotherapy are possible alternatives in cases of more than one metastasis site. There are no clinical guidelines establishing correct management.
Conclusion: Urinary diversion stoma metastasis secondary to urothelial carcinoma is a rare entity. Direct implantation during the surgical act, or hematogenous, lymphatic, or mixed dissemination, could justify metastatic implantation.
Referencias
Babjuk M, Böhle A, Burger M, Capoun O, Cohen D, Compérat EM, et al. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol. 2017;71(3):447–61. doi: 10.1016/j.eururo.2016.05.041
Shinagare AB, Ramaiya NH, Jagannathan JP, Fennessy FM, Taplin M-E, Van den Abbeele AD. Metastatic pattern of bladder cancer: correlation with the characteristics of the primary tumor. AJR Am J Roentgenol. 2011;196(1):117–22. doi: 10.2214/AJR.10.5036
Sánchez Zalabardo D, López Ferrandis J, Arocena García-Tapia J, Sanz Pérez G, Zudaire Bergera J, Berían Polo Jm. Recurrent urothelial tumor in orthotopic neobladder. Actas Urol Esp. 2001;25(8):600–2. doi: 10.1016/s0210-4806(01)72681-2
Barba Abad JF, Tolosa Eizaguirre E, Rincón Mayans A, Berian Polo J. Recidiva tumoral en sustitución vesical ortotópica. A propósito de dos casos y revisión de la literatura médica. Actas Urológicas Españolas. 2010;34(3):295–7. doi: 10.1016/j.acuro.2009.10.002
Curran FT, Fuggle WJ. Transitional cell carcinoma in an ileal conduit. Postgraduate Medical Journal. 1986;62(730):769–71. doi: 10.1136/pgmj.62.730.769
Rosvanis TK, Rohner TJ, Abt AB. Transitional cell carcinoma in an ileal conduit. Cancer. 1989;63(6):1233–6. doi: https://doi.org/10.1002/1097-0142(19890315)63:6<1233::AID-CNCR2820630633>3.0.CO;2-7
Elawdy MM, Osman Y, Taha DE, El-Halwagy S. Muscle-invasive bladder and urethral cancer recurrence after surgical management of upper tract urothelial carcinoma: A review of 305 patients. Turk J Urol. 2018;44(3):213–20. doi: 10.5152/tud.2018.19677
Grabstald Harry. Carcinoma of Ileal Bladder Stoma. Journal of Urology. 1974;112(3):332–4. doi: 10.1016/S0022-5347(17)59722-0
Gupta C. & Rajeev K. Ileal Conduit stoma site metastasis in squamous cell carcinoma of urinary bladder. BJUI. 2011 Jun 24.
Inobe T, Kanda K, Murakami Y, Tsuji M, Tamura M, Kagawa S. Recurrent bladder adenocarcinoma in an ileal conduit stoma: A case report. International Journal of Urology. 1999;6(9):467–70. doi: https://doi.org/10.1046/j.1442-2042.1999.00094.x
Kunju Lakshmi P., You Li, Zhang Yingxi, Daignault Stephanie, Montie James E., Lee Cheryl T. Lymphovascular Invasion of Urothelial Cancer in Matched Transurethral Bladder Tumor Resection and Radical Cystectomy Specimens. Journal of Urology. 2008;180(5):1928–32. doi: 10.1016/j.juro.2008.07.056
