Tokitaka Satoshi, Hirata Hiroshi, Shimo Reiko, Shintaro Oka, Shiraishi Koji
Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, JPN.
Cureus. 2024 Dec 4;16(12):e75122. doi: 10.7759/cureus.75122. eCollection 2024 Dec.
Cardiac metastases from bladder cancer are extremely rare and typically associated with a poor prognosis. We here report a case of a 74-year-old woman who had been diagnosed with multiple bladder cancer and later developed pelvic recurrence and multiple bone metastases. Second-line pembrolizumab treatment achieved complete remission. Three years and three months after the second-line pembrolizumab treatment, a routine computed tomography scan revealed a right atrial mass and bilaterally enlarged adrenal glands. Primary tumors were not identified, suggesting that the tumor in the right atrium and the enlargement of the adrenal glands were recurrences of the previous bladder cancer. Enfortumab-vedotin (EV) was chosen as a subsequent treatment. One month after this treatment, the tumor in the right atrium was undetectable and her adrenal glands had shrunk. Her complete response was maintained six months after starting subsequent treatment. To the best of our knowledge, this is the first case report of complete remission of bladder cancer metastasis to the right atrium induced by EV.
膀胱癌的心脏转移极为罕见，通常预后较差。我们在此报告一例74岁女性，她被诊断为多发性膀胱癌，后来出现盆腔复发和多处骨转移。二线帕博利珠单抗治疗实现了完全缓解。在二线帕博利珠单抗治疗三年零三个月后，一次常规计算机断层扫描显示右心房有肿块，双侧肾上腺肿大。未发现原发性肿瘤，提示右心房肿瘤和肾上腺肿大是先前膀胱癌的复发。选择恩沃利单抗（EV）作为后续治疗。该治疗一个月后，右心房肿瘤无法检测到，肾上腺也已缩小。开始后续治疗六个月后，她维持了完全缓解状态。据我们所知，这是首例关于EV诱导膀胱癌转移至右心房完全缓解的病例报告。
