Ibrahimi Ahmed, Ouskri Salim, El Abidi Hamza, Boualaoui Imad, El Sayegh Hachem, Nouini Yassine
Urology, Ibn Sina Universitary Hospital, Rabat, Morocco.
Urology, Ibn Sina Universitary Hospital, Rabat, Morocco.
Int J Surg Case Rep. 2025 May;130:111250. doi: 10.1016/j.ijscr.2025.111250. Epub 2025 Apr 11.
Urothelial carcinoma (UC) is a common malignancy with a high propensity for metastasis, typically to the lungs, liver, bones, and lymph nodes. Metastasis to the psoas muscle is exceedingly rare and poorly documented.
We report a 46-year-old chronic smoker with a history of muscle-invasive bladder UC treated with cystectomy and urinary diversion. After two years of lost follow-up, he presented with hematuria, lumbar pain, and a large left psoas tumor confirmed as recurrent UC. Surgical resection of the psoas and excretory tract tumor was performed, coupled with nutritional and rehabilitative support.
Psoas metastasis in UC represents a diagnostic and therapeutic challenge. A multimodal approach, including surgery, systemic therapy, and supportive care, can improve outcomes. Literature emphasizes poor prognosis in multifocal or visceral metastases, underscoring the aggressive nature of advanced UC.
This case highlights the importance of comprehensive imaging and multidisciplinary care in managing rare UC metastases. Further research is needed to refine treatment strategies and improve outcomes.
尿路上皮癌（UC）是一种常见的恶性肿瘤，具有较高的转移倾向，通常转移至肺、肝、骨和淋巴结。转移至腰大肌极为罕见，且文献记载较少。
我们报告一名46岁的慢性吸烟者，有肌肉浸润性膀胱UC病史，接受了膀胱切除术和尿流改道术。在失访两年后，他出现血尿、腰痛，左腰大肌有一个大肿瘤，确诊为复发性UC。对腰大肌和排泄道肿瘤进行了手术切除，并给予营养和康复支持。
UC中的腰大肌转移是一个诊断和治疗难题。多模式方法，包括手术、全身治疗和支持治疗，可以改善预后。文献强调多灶性或内脏转移的预后较差，凸显了晚期UC的侵袭性。
本病例强调了在处理罕见的UC转移时综合成像和多学科护理的重要性。需要进一步研究以完善治疗策略并改善预后。
