Neurologic complications of bladder carcinoma: a review of 359 cases.

BACKGROUND

Carcinoma of the urinary bladder accounts for approximately 2% of all malignant tumors and usually spreads through both local invasion and hematogenous dissemination. In the current study, the authors reviewed a large series of patients to determine the nature and frequency of neurologic complications.

METHODS

In the current study, the authors reviewed the records of 359 patients with bladder carcinoma who were treated at the study institution between 1962-2001.

RESULTS

Fifty-two patients (14%) were reported to have neurologic complications. Complications resulting from neurologic metastases were relatively infrequent (5%). Seven patients (2%) had lumbosacral plexopathies and 6 patients (2%) had metastatic epidural spinal cord compression. Brain metastases were present in only 4 patients (1%). Nonmetastatic complications were more common than metastatic complications and were comprised of metabolic encephalopathies in 24 patients (7%), peripheral neuropathies in 9 patients (2.5%), cerebral infarctions in 6 patients (2%), and seizures in 5 patients (1%). No cases of neurologic infection or carcinomatous meningitis were reported.

CONCLUSIONS

The results of the current study demonstrate that neurologic complications are relatively uncommon in patients with bladder carcinoma and that local extension into peripheral nerves or bone, rather than hematogenous dissemination, is the most common cause of neurologic complications resulting from bladder carcinoma.