Meningeal carcinomatosis from bladder cancer: A case report and review of the literature

Umezawa,Yuta; Shirotake,Suguru; Kaneko,Go; Nishimoto,Koshiro; Okada,Yoshitaka; Uchino,Akira; Yasuda,Masanori; Oyama,Masafumi

doi:10.3892/mco.2019.1820

Meningeal carcinomatosis from bladder cancer: A case report and review of the literature

Authors:
- Yuta Umezawa
- Suguru Shirotake
- Go Kaneko
- Koshiro Nishimoto
- Yoshitaka Okada
- Akira Uchino
- Masanori Yasuda
- Masafumi Oyama
View Affiliations

Affiliations: Department of Uro-Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan, Department of Diagnostic Radiology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan, Department of Diagnostic Pathology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan
Published online on: March 5, 2019 https://doi.org/10.3892/mco.2019.1820
Pages: 506-510

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

A 66‑year‑old Japanese male patient was referred to Saitama Medical University International Medical Center for treatment of bladder cancer (clinical stage T2 or higher without metastasis), and underwent radical cystectomy with pelvic lymphadenectomy. The histopathological diagnosis was high‑grade urothelial carcinoma (pathological stage T2bN2, ly1, v0) and 2 cycles of adjuvant systemic chemotherapy (gemcitabine plus cisplatin) were administered. At 15 months after the operation, mediastinal and lung hilar lymph nodes and multiple bone metastases were identified on computed tomography imaging. After 3 cycles of the previous regimen as salvage systemic chemotherapy, the lymph node metastases had shrunk and the bone metastases were stable; therefore, further chemotherapy was planned. At 26 days after the initiation of the 4th cycle, the patient felt nausea and lower limb weakness. Spinal and brain magnetic resonance imaging with contrast medium revealed diffuse enhancement at the surface of the spinal cord and brain. In addition, abnormal signal intensity in the subarachnoid space was observed on fluid‑attenuated inversion recovery imaging; therefore, the patient was diagnosed with meningeal carcinomatosis (MC). Treatment, including whole‑brain radiotherapy, was planned for MC; however, the patient's condition rapidly worsened and he succumbed to the disease 14 days after the diagnosis of MC. The definitive diagnosis of MC was confirmed at autopsy.

View Figures

View References

1	Le Rhun E, Weller M, Brandsma D, Van den Bent M, de Azambuja E, Henriksson R, Boulanger T, Peters S, Watts C, Wick W, et al EANO Executive Board and ESMO Guidelines Committee, : EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with leptomeningeal metastasis from solid tumours. Ann Oncol. 28 (Suppl 4):iv84–iv99. 2017. View Article : Google Scholar : PubMed/NCBI
2	Chamberlain MC: Leptomeningeal metastasis. Curr Opin Oncol. 22:627–635. 2010. View Article : Google Scholar : PubMed/NCBI
3	Roth P and Weller M: Management of neoplastic meningitis. Chin Clin Oncol. 4:262015.PubMed/NCBI
4	Le Rhun E, Taillibert S and Chamberlain MC: Carcinomatous meningitis: Leptomeningeal metastases in solid tumors. Surg Neurol Int. 4 (Suppl 4):S265–S288. 2013. View Article : Google Scholar : PubMed/NCBI
5	Gleissner B and Chamberlain MC: Neoplastic meningitis. Lancet Neurol. 5:443–452. 2006. View Article : Google Scholar : PubMed/NCBI
6	van der Ree TC, Dippel DW, Avezaat CJ, Sillevis Smitt PA, Vecht CJ and van den Bent MJ: Leptomeningeal metastasis after surgical resection of brain metastases. J Neurol Neurosurg Psychiatry. 66:225–227. 1999. View Article : Google Scholar : PubMed/NCBI
7	Hust MH and Pfitzer P: Cerebrospinal fluid and metastasis of transitional cell carcinoma of the bladder. Acta Cytol. 26:217–223. 1982.PubMed/NCBI
8	Mandell S, Wernz J, Morales P, Weinberg H and Steinfeld A: Carcinomatous meningitis from transitional cell carcinoma of bladder. Urology. 25:520–521. 1985. View Article : Google Scholar : PubMed/NCBI
9	Hussein AM, Savaraj N, Feun LG, Ganjei P and Donnelly E: Carcinomatous meningitis from transitional cell carcinoma of the bladder: Case report. J Neurooncol. 7:255–260. 1989. View Article : Google Scholar : PubMed/NCBI
10	Bishop JR Jr, Moul JW, Maldonado L and McLeod DG: Transitional cell carcinomatous meningitis after M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) chemotherapy. Urology. 36:373–377. 1990. View Article : Google Scholar : PubMed/NCBI
11	Raghavan D and Chye RW: Treatment of carcinomatous meningitis from transitional cell carcinoma of the bladder. Br J Urol. 67:438–440. 1991. View Article : Google Scholar : PubMed/NCBI
12	Eng C, Cunningham D, Quade BJ, Schwamm L, Kantoff PW and Skarin AT: Meningeal carcinomatosis from transitional cell carcinoma of the bladder. Cancer. 72:553–557. 1993. View Article : Google Scholar : PubMed/NCBI
13	Santarossa S, Vaccher E, Balestreri L, Volpe R and Tirelli U: Solitary meningeal recurrence in a patient with transitional cell carcinoma of the bladder with locally bulky disease at presentation. J Neurooncol. 35:141–143. 1997. View Article : Google Scholar : PubMed/NCBI
14	Cozzarini C, Reni M, Mangili F, Baldoli MC, Galli L and Bolognesi A: Meningeal carcinomatosis from transitional cell carcinoma of the bladder: Report of two cases and review of the literature. Cancer Invest. 17:402–407. 1999. View Article : Google Scholar : PubMed/NCBI
15	Isaka T, Maruno M, Sato M, Kinoshita M, Nishida T, Kiyohara H and Yoshimine T: Brain metastasis from small-cell neuroendocrine carcinoma of the urinary bladder: A case report. Brain Tumor Pathol. 19:117–122. 2002. View Article : Google Scholar : PubMed/NCBI
16	Bruna J, Rojas-Marcos I, Martínez-Yelamos S, Català I, Vidaller A, Galán C, Krupinski J and Rubio F: Meningeal carcinomatosis as the first manifestation of a transitional cell carcinoma of the bladder. J Neurooncol. 63:63–67. 2003. View Article : Google Scholar : PubMed/NCBI
17	Sugimori K, Kobayashi K, Hayashi M, Sakai N, Sasaki M and Koshino Y: Leptomeningeal carcinomatosis from urinary bladder adenocarcinoma: A clinicopathological case study. Neuropathology. 25:89–94. 2005. View Article : Google Scholar : PubMed/NCBI
18	Uncu D, Arpaci F, Beyzadeoglu M, Gunal A, Surenkok S, Ozturk M and Ozet A: Meningeal carcinomatosis: An extremely rare involvement of urinary bladder carcinoma. Tumori. 96:352–354. 2010. View Article : Google Scholar : PubMed/NCBI
19	Bowen CD, Von Burton G, Bargen RC, Madonia P, Zhang S, Toledo EG, Zweig R and Pant C: Carcinomatous meningitis secondary to transitional cell bladder cancer. South Med J. 103:809–812. 2010. View Article : Google Scholar : PubMed/NCBI
20	Butchart C, Dahle-Smith A, Bissett D, Mackenzie JM and Williams DJ: Isolated Meningeal Recurrence of Transitional Cell Carcinoma of the Bladder. Case Rep Oncol. 3:171–175. 2010. View Article : Google Scholar : PubMed/NCBI
21	Zada G and Chen TC: A novel method for administering intrathecal chemotherapy in patients with leptomeningeal metastases and shunted hydrocephalus: case report. Neurosurgery. 67:onsE306–307. 2010.PubMed/NCBI
22	Kastritis E, Zagouri F, Dimopoulos MA and Papadimitriou CA: Carcinomatous meningitis from transitional cell carcinoma of the urinary bladder. J BUON. 16:373–374. 2011.PubMed/NCBI
23	Tadepalli S, Coleman T, Hacket LA and Liles GB: Carcinomatous meningitis: The natural history of successfully treated metastatic bladder cancer. Case Rep Oncol. 4:406–412. 2011. View Article : Google Scholar : PubMed/NCBI
24	Molek KR, Seili-Bekafigo I, Štemberger C, Jonjić N, Đordević G and Duletić-Načinović A: Plasmacytoid urothelial carcinoma - diagnostic challenge in cytology. Diagn Cytopathol. 41:369–373. 2013. View Article : Google Scholar : PubMed/NCBI
25	Yust-Katz S, Mathis S and Groves MD: Leptomeningeal metastases from genitourinary cancer: The University of Texas MD Anderson Cancer Center experience. Med Oncol. 30:4292013. View Article : Google Scholar : PubMed/NCBI
26	Swallow TW, Mabbutt S and Bell CR: Muscle invasive bladder cancer culminating with leptomeningeal carcinomatosis. Can Urol Assoc J. 9:E903–E904. 2015. View Article : Google Scholar : PubMed/NCBI
27	Teyssonneau D, Daste A, Dousset V, Hoepffner JL, Ravaud A and Gross-Goupil M: Metastatic non-muscle invasive bladder cancer with meningeal carcinomatosis: Case report of an unexpected response. BMC Cancer. 17:3232017. View Article : Google Scholar : PubMed/NCBI
28	Alfred Witjes J, Lebret T, Compérat EM, Cowan NC, De Santis M, Bruins HM, Hernández V, Espinós EL, Dunn J, Rouanne M, et al: Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer. Eur Urol. 71:462–475. 2017. View Article : Google Scholar : PubMed/NCBI
29	Wu PF, Lin CH, Kuo CH, Chen WW, Yeh DC, Liao HW, Huang SM, Cheng AL and Lu YS: A pilot study of bevacizumab combined with etoposide and cisplatin in breast cancer patients with leptomeningeal carcinomatosis. BMC Cancer. 15:2992015. View Article : Google Scholar : PubMed/NCBI
30	Zagouri F, Sergentanis TN, Bartsch R, Berghoff AS, Chrysikos D, de Azambuja E, Dimopoulos MA and Preusser M: Intrathecal administration of trastuzumab for the treatment of meningeal carcinomatosis in HER2-positive metastatic breast cancer: A systematic review and pooled analysis. Breast Cancer Res Treat. 139:13–22. 2013. View Article : Google Scholar : PubMed/NCBI
31	Gion M, Remon J, Caramella C, Soria JC and Besse B: Symptomatic leptomeningeal metastasis improvement with nivolumab in advanced non-small cell lung cancer patient. Lung Cancer. 108:72–74. 2017. View Article : Google Scholar : PubMed/NCBI
32	Massari F, Di Nunno V, Cubelli M, Santoni M, Fiorentino M, Montironi R, Cheng L, Lopez-Beltran A, Battelli N and Ardizzoni A: Immune checkpoint inhibitors for metastatic bladder cancer. Cancer Treat Rev. 64:11–20. 2018. View Article : Google Scholar : PubMed/NCBI