Damascus University, Al-Assad University Hospital, Damascus, Syria.
Faculty of Medicine, Hama University, Assi Square, Hama, Syria.
BMC Urol. 2024 Jun 15;24(1):127. doi: 10.1186/s12894-024-01516-6.
Carcinoma in situ of the bladder is a high-grade cancer that originates in the superficial layer of the bladder. It has the potential to invade nearby organs, and it can spread through blood and lymphatic circulation to distant parts of the body.
A 58-year-old non-smoker male presented with gross and microscopic hematuria. His family history included his father's recent bladder cancer. Initial investigations showed hematuria, inflammation, negative urine culture, digital rectal examination revealed an enlarged right lobe of the prostate, and an elevated Prostate-Specific Antigen level. Histopathological examination of samples taken from the bladder mucosa and the prostate confirmed urothelial carcinoma in situ in the bladder and prostate. Further evaluation revealed no other metastasis. The tumor was classified as T4aN0M0. The patient underwent radical cystoprostatectomy and histopathological examination showed that the tumor invading the muscularis propria of the bladder as well as the prostatic glands, but no malignancy was found in prostatic urethra and other areas. The patient was discharged three weeks post-operation and completed on adjuvant chemotherapy consisting of Gemcitabine, and Cisplatin to prevent of relapse. The patient is currently in a good healthy.
The occurrence of bladder cancer metastasizing to the prostate without involving the prostatic urethra is uncommon and requires precise diagnostic techniques for accurate tumor classification. Early management is advised to enhance the prognosis for the patient.
膀胱原位癌是一种起源于膀胱浅层的高级别癌症。它有可能侵犯附近的器官,也可以通过血液和淋巴循环扩散到身体的远处。
一位 58 岁的非吸烟者男性出现肉眼血尿和镜下血尿。他的家族史包括其父亲最近被诊断出膀胱癌。初步检查显示血尿、炎症、尿液培养阴性、直肠指检发现右侧前列腺叶肿大,前列腺特异性抗原水平升高。膀胱黏膜和前列腺组织样本的组织病理学检查证实了膀胱和前列腺的原位尿路上皮癌。进一步评估未发现其他转移。肿瘤分类为 T4aN0M0。患者接受了根治性膀胱前列腺切除术,组织病理学检查显示肿瘤侵犯膀胱固有肌层和前列腺腺体,但在前列腺尿道和其他部位未发现恶性肿瘤。患者术后三周出院,并完成了吉西他滨和顺铂辅助化疗,以预防复发。目前患者身体状况良好。
膀胱癌不侵犯前列腺尿道而转移至前列腺的情况并不常见,需要精确的诊断技术来准确进行肿瘤分类。建议早期进行管理,以提高患者的预后。