Henmi Fumiaki, Ukai Kayako, Nakayama Atsuhito, Takazawa Yutaka, Uesaka Yoshikazu
Department of Neurology, Toranomon Hospital, Tokyo, JPN.
Department of Pathology, The University of Tokyo, Tokyo, JPN.
Cureus. 2024 Feb 21;16(2):e54643. doi: 10.7759/cureus.54643. eCollection 2024 Feb.
This case report describes a rare and aggressive presentation of plasmacytoid urothelial carcinoma (PUC) with carcinomatous meningitis, hydrocephalus, extensive organ involvement, and extremely elevated serum CA19-9 levels. Autopsy findings revealed that PUC of the urinary bladder origin caused carcinomatous meningitis and hydrocephalus, with exacerbation of hydrocephalus as the direct cause of death. Immunohistochemical studies confirmed the bladder origin of PUC, and PUC cells were positive for CA19-9, a tumor marker commonly associated with gastrointestinal malignancies, suggesting that the markedly high serum CA19-9 level was related to the tumor-producing mechanism.
本病例报告描述了一例罕见的侵袭性浆细胞样尿路上皮癌（PUC），伴有癌性脑膜炎、脑积水、广泛的器官受累以及血清CA19-9水平极度升高。尸检结果显示，起源于膀胱的PUC导致了癌性脑膜炎和脑积水，脑积水加重是直接死因。免疫组化研究证实了PUC的膀胱起源，且PUC细胞CA19-9呈阳性，CA19-9是一种通常与胃肠道恶性肿瘤相关的肿瘤标志物，提示血清CA19-9水平显著升高与肿瘤产生机制有关。
