Metastasis of Transitional Cell Carcinoma to the Lower Abdominal Wall 20 Years after Cystectomy

Abstract

Iatrogenic implantation has been the main cause in the majority of cases of transitional call carcinoma (TCC) with metastasis to the abdominal wall. A 66-year-old woman had undergone radical cystectomy 20 years prior to presenting. Radiological investigations revealed one mass in the left lower abdominal wall and one mass in the right inguinal area. She underwent wide excision of the lesions that revealed metastasis of TCC. This report describes this case of a woman with bladder carcinoma who developed a metastasis in the anterior abdominal wall following an apparent disease-free interval of 20 years.

Brain and Skin Metastasis From Urothelial Carcinoma of the Bladder

“…There are four mechanisms of metastatic dissemination by which the skin may be involved: 1) direct invasion from an underlying neoplasm, 2) iatrogenic implantation from an operation, 3) lymphatic spread, or 4) hematogenous spread [2,9]. In this case, similar to a patient reported by Ku et al [8], skin metastasis was likely by hematogenous spread rather than other mechanisms. However, brain and skin metastasis is regarded as a late manifestation of systemic spread.…”

“…According to the Brain Tumor Registry of Japan, only 0.6% of metastatic brain tumors were from bladder cancers [8]. In another study, central nervous system metastases were found in fewer than 1% of cases [1].…”

Early metastasis to anterior abdominal wall following radical cystectomy: A rare presentation

“…After resection of a high-grade bladder tumor, the most common cause of involvement of abdominal wall is iatrogenic implantation. [ 3 ] Such involvement may occur even without visible contamination of the surgical site or perivesical spread, likely cause being microscopic seedings. Some reports mention port site metastasis after laparoscopic and robotic surgeries for TCC.…”

“…presented a case of a 66-year-old woman with metastasis of TCC to the lower abdominal wall 20 years after radical cystectomy. [ 3 ] Salemis et al . presented a case of cutaneous metastasis 17 months after cystectomy.…”

Low grade papillary transitional cell carcinoma pelvic recurrence masquerading as high grade invasive carcinoma, ten years after radical cystectomy

“…The histology from skin recurrence was consistent with well-differentiated TCC. Subsequently patient developed a pelvic recurrence in spite of chemotherapy [ 10 ]. In our experience too the patient failed to respond to the cisplatin based chemotherapy as reported in above mentioned study.…”