Wang Gang, Wang Li-Li, Deng Dian-Dian, Xu Han-Xin, Yu Sheng-Hui, Wang Yu
First Clinical Medical School of Lanzhou University, No. 1 Donggang West Road, Chengguan District, Lanzhou, 730000, China.
Department of Radiology, First Hospital of Lanzhou University, No. 1 Donggang West Road,Chengguan District, Lanzhou, 730000, China.
BMC Urol. 2025 Apr 14;25(1):90. doi: 10.1186/s12894-025-01783-x.
Bladder cancer is one of the most common cancers worldwide, and urothelial carcinoma is the most common form of bladder cancer. Gastric metastasis of urothelial carcinoma of the bladder is a rare condition. Cystoscopy plays an important role in the diagnosis of bladder cancer; however, it is an invasive procedure that may affect the patient's prognosis and does not allow for the observation of cancer infiltration and metastasis. Therefore, non-invasive imaging is increasingly becoming the most appropriate method for the diagnosis and follow-up of urothelial carcinoma.
A 51-year-old female patient presented with pain in the lower abdomen and lower back for more than 2 months. This was a case of bladder urothelial carcinoma with gastric metastases, confirmed by pathology using dual-layer detector computed tomography (CT) spectral multiparametric imaging. The stage of the cancer was cT3N+M1b IVB, and the dimensions were 11.6 mm×42.2 mm×44.4 mm. The energy spectrum multiparameter image shows good consistency in the quantitative measurement of multiple nodules on the gastric wall and bladder wall masses (single energy 40 keV-CT value, iodine concentration, effective atomic number), and the spectral curve runs basically consistent. After 5 months of chemotherapy, the slope values of the spectral curve were 3.74 and 3.09 in the initial and follow-up spectral CT scans, respectively, reflecting the improvement of bladder wall lesions after treatment.
The present case is a very rare case of bladder urothelial carcinoma with gastric metastasis. We applied multi-parameter quantitative indicators of spectral CT to more accurately show the homology characteristics of gastric metastasis and bladder cancer, and also reflected the different sources of cystic lesions in the left adnexal region from bladder cancer and gastric metastasis. Spectral CT has a promising application prospect in detecting the homology of different lesions and diagnosing urothelial gastric metastasis carcinoma.
膀胱癌是全球最常见的癌症之一，其中尿路上皮癌是膀胱癌最常见的形式。膀胱尿路上皮癌的胃转移是一种罕见情况。膀胱镜检查在膀胱癌诊断中发挥着重要作用；然而，它是一种侵入性操作，可能会影响患者的预后，并且无法观察到癌症浸润和转移情况。因此，非侵入性成像越来越成为尿路上皮癌诊断和随访的最合适方法。
一名51岁女性患者出现下腹部和下背部疼痛2个多月。这是一例经双层探测器计算机断层扫描（CT）光谱多参数成像病理证实的膀胱尿路上皮癌伴胃转移病例。癌症分期为cT3N+M1b IVB期，尺寸为11.6 mm×42.2 mm×44.4 mm。能谱多参数图像显示胃壁和膀胱壁肿块上多个结节的定量测量（单能量40 keV-CT值、碘浓度、有效原子序数）具有良好的一致性，光谱曲线基本一致。化疗5个月后，初始和随访光谱CT扫描中光谱曲线的斜率值分别为3.74和3.09，反映了治疗后膀胱壁病变的改善。
本病例是一例非常罕见的膀胱尿路上皮癌伴胃转移病例。我们应用光谱CT的多参数定量指标更准确地显示了胃转移与膀胱癌的同源性特征，也反映了左附件区囊性病变与膀胱癌和胃转移的不同来源。光谱CT在检测不同病变的同源性和诊断尿路上皮胃转移癌方面具有广阔的应用前景。
