Wesemann Logan, Thomas Brian, Kim Daniel, Taylor Zachariah, McCoo Matthew, McMahon Gregory C
Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA.
Main Line Health, Division of Urology, Wynnewood, PA, USA.
Urol Case Rep. 2025 Aug 25;62:103178. doi: 10.1016/j.eucr.2025.103178. eCollection 2025 Sep.
Muscle-invasive bladder cancer (MIBC) with cardiac metastasis typically carries a very poor prognosis. A Black woman in her 70s developed high-grade urothelial carcinoma with squamous differentiation invading the bladder muscle. Despite chemotherapy, radiation, and nephrostomy, the disease progressed. Six months after diagnosis, imaging revealed metastases to the heart and liver with biopsy showing a rare p63-positive, CK7-negative phenotype. Following a single dose of pembrolizumab, she died within three weeks, likely from cardiogenic shock. In CK7-negative variant urothelial carcinoma, early cardiac imaging and expanded immunohistochemical panels may improve detection of atypical metastases.
伴有心脏转移的肌层浸润性膀胱癌（MIBC）通常预后极差。一名70多岁的黑人女性患了伴有鳞状分化的高级别尿路上皮癌，肿瘤侵犯膀胱肌层。尽管接受了化疗、放疗和肾造瘘术，病情仍进展。诊断后6个月，影像学检查显示心脏和肝脏有转移，活检显示为罕见的p63阳性、CK7阴性表型。在单次使用派姆单抗后，她在三周内死亡，可能死于心源性休克。在CK7阴性变异型尿路上皮癌中，早期心脏成像和扩展的免疫组化检测可能会改善对非典型转移的检测。
