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Unusual presentation of more common disease/injury
CASE REPORT
Urothelial carcinoma in an orthotopic neobladder: an unusual pattern of recurrence and metastasis
  1. Veerle H Groen1,
  2. Tycho M T W T Lock1,
  3. Bart de Keizer2,
  4. Simon Horenblas3,
  5. Richard P Meijer1
  1. 1Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
  2. 2Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
  3. 3Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
  1. Correspondence to Dr Richard P Meijer, rmeijer6{at}umcutrecht.nl

Summary

We report a case of a 65-year-old patient with muscle invasive bladder cancer that was treated with neoadjuvant chemotherapy, followed by radical cystoprostatectomy with pelvic lymph node dissection and orthotopic neobladder according to Hautmann. Nine years later, routine follow-up showed local recurrence in the neobladder and metastatic disease of the urothelial carcinoma in the related mesenteric lymph nodes. The entire neobladder specimen was removed including the mesentery of the neobladder. Based on the anatomical lymph drainage of the ileal neobladder, we considered the metastatic disease in the mesentery lymph node as locoregional disease spread. This case shows that such locoregional lymph node metastasis may be amenable to treatment by induction chemotherapy and radical surgery.

  • urological cancer
  • urological surgery

https://doi.org/10.1136/bcr-2017-221052

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    Footnotes

    • Contributors All persons who meet the authorship criteria are listed below as authors: identification and management of the patient of this case report: RPM. Overall guarantor: RPM. Conception and design of the work: VHG, TMTWTL, BdK, SH, RPM. Responsible for images: BdK. Drafting and revising the manuscript: VHG. Revising of the manuscript critically for important and intellectual content: TMTWTL, SH, RPM. Final approval of the version to be published: VHG, TMTWTL, BdK, SH, RPM. Authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: VHG, TMTWTL, SH, RPM.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.