Fukuta Kyotaro, Izaki Hirofumi, Shiozaki Keito, Nakanishi Ryoichi, Inai Tohru, Kataoka Hideyuki, Kudo Eiji, Kanda Kazuya
Department of Urology Tokushima Prefectural Central Hospital Tokushima Japan.
Department of General Medicine Tokushima Prefectural Central Hospital Tokushima Japan.
IJU Case Rep. 2021 Jun 24;4(5):310-313. doi: 10.1002/iju5.12334. eCollection 2021 Sep.
The nested variant of urothelial carcinoma is rare and shows poor prognosis. We report a case of complete response to pembrolizumab in recurrent nested variant.
A 50-year-old man visited another hospital with hematuria and weight loss. Clinical stage T4aN0M0 bladder cancer and acute renal failure were diagnosed. He was referred to our hospital and underwent radical cystectomy. Histological examination showed pathological stage T4aN2 nested variant of urothelial carcinoma. He received 3 cycles of gemcitabine and carboplatin adjuvant chemotherapy. However, para-aortic lymph node metastasis appeared 7 months after cystectomy. He received pembrolizumab as systemic chemotherapy. After 10 cycles, the lesion remained undetectable and we evaluated the response as complete. He has received 18 cycles in total and no recurrences or metastases have been observed.
Pembrolizumab may offer effective treatment for nested variant of urothelial carcinoma.
尿路上皮癌的巢状变异型罕见，预后较差。我们报告一例复发性巢状变异型对帕博利珠单抗完全缓解的病例。
一名50岁男性因血尿和体重减轻前往另一家医院就诊。诊断为临床分期T4aN0M0膀胱癌和急性肾衰竭。他被转诊至我院并接受了根治性膀胱切除术。组织学检查显示为病理分期T4aN2尿路上皮癌巢状变异型。他接受了3个周期的吉西他滨和卡铂辅助化疗。然而，膀胱切除术后7个月出现主动脉旁淋巴结转移。他接受帕博利珠单抗作为全身化疗。10个周期后，病变仍无法检测到，我们评估反应为完全缓解。他总共接受了18个周期的治疗，未观察到复发或转移。
帕博利珠单抗可能为尿路上皮癌巢状变异型提供有效的治疗。
