Ando Takashi, Katagiri Akiyoshi, Nakayama Ryo, Sakai Takeshi, Mizusawa Takaki
Department ofUrology Niigata Prefectural Central Hospital Jouetsu, Niigata Japan.
Department of Pathology Niigata Prefectural Central Hospital Jouetsu, Niigata Japan.
IJU Case Rep. 2018 Oct 3;1(1):25-28. doi: 10.1002/iju5.12023. eCollection 2018 Nov.
A part of hypercalcemia is a paraneoplastic syndrome. Its association with lymph node metastasis of bladder cancer has been infrequently reported in the literature.
A 75-year-old male presented with gross hematuria and was diagnosed with bladder cancer without metastasis. Following neoadjuvant chemotherapy, radical cystectomy was performed. The surgical margin was negative. The bladder cancer was classified as pT3bN0 and mainly constituted squamous differentiated urothelial carcinoma and sarcomatoid variant. His perioperative serum calcium levels were normal. At 6 months of surgery, computed tomography revealed lymph node enlargement, and additional 2 weeks later, he developed epileptic seizures with a serum corrected calcium level of 18.7 mg/dL. He was diagnosed with hypercalcemia caused by the lymph node metastasis of bladder cancer. Despite receiving several supportive therapies for 22 days, he died.
Hypercalcemia associated with bladder cancer is highly resistant to existing therapy, particularly when caused by cancer metastasis.
高钙血症的一部分是副肿瘤综合征。其与膀胱癌淋巴结转移的关联在文献中鲜有报道。
一名75岁男性因肉眼血尿就诊，被诊断为无转移的膀胱癌。新辅助化疗后，进行了根治性膀胱切除术。手术切缘阴性。膀胱癌分类为pT3bN0，主要由鳞状分化尿路上皮癌和肉瘤样变体组成。他的围手术期血清钙水平正常。术后6个月，计算机断层扫描显示淋巴结肿大，再过2周后，他出现癫痫发作，血清校正钙水平为18.7mg/dL。他被诊断为膀胱癌淋巴结转移导致的高钙血症。尽管接受了22天的多种支持治疗，他还是去世了。
与膀胱癌相关的高钙血症对现有治疗高度耐药，尤其是由癌症转移引起时。
