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Review
. 2022 Apr 3;16(1):131.
doi: 10.1186/s13256-022-03368-w.

Bladder metastasis with additional metastases in multiple other organs 4 years after radical nephrectomy for clear cell renal cell carcinoma: a case report and review of the literature

Masayasu Urushibara  1 , Masakazu Nagata  2 , Taisuke Okumura  2 , Hideto Kano  2 , Yuuki Matsumoto  2 , Shinichiro Tatsuoka  2 , Tsunehiro Nenohi  2 , Takeshi Shirakawa  2 , Daisuke Kato  2 , Masashi Kawamoto  3 , Kazuhiro Ishizaka  2 , Noriyuki Matsutani  4
Affiliations
Review

Bladder metastasis with additional metastases in multiple other organs 4 years after radical nephrectomy for clear cell renal cell carcinoma: a case report and review of the literature

Masayasu Urushibara et al. J Med Case Rep. .

Abstract

Background: Renal cell carcinoma rarely metastasizes to the bladder, and its biological behavior is not yet fully understood.

Case presentation: In our case (54-year-old Japanese woman), computed tomography evaluation suggested the presence of a bladder metastasis, associated with additional metastases in the lungs, mediastinal lymph nodes, ribs, and renal bed, 4 years after radical nephrectomy for renal cell carcinoma. The histological findings of the metastatic bladder tumor were consistent with those of clear cell carcinoma. The mediastinal lymph node, rib, and renal bed metastases responded to treatment with an immune checkpoint inhibitor administered for 12 months after surgery for the bladder and lung metastases. In patients with bladder metastasis, absence of metastases in other organs and an interval of more than 1 year after nephrectomy are known to be favorable prognostic factors. Interestingly, in our case, the bladder metastasis was detected more than 1 year after nephrectomy, which was a favorable factor, but there were also metastases in other organs, which was an unfavorable factor. Therefore, we reviewed the literature, including that pertaining to targeted therapy and immune checkpoint inhibitor therapy published in the last two decades, to analyze the clinical significance of the presence of additional metastasis in other organs in renal cell carcinoma (clear cell type, which is the predominant subtype) patients with bladder metastasis.

Conclusions: Patients with bladder metastasis after nephrectomy for renal cell carcinoma also having metastases in other organs may respond to targeted therapy and immune checkpoint inhibitor therapy. This may suggest that the interval to relapse in the bladder after nephrectomy may be a more important prognostic factor than the presence of synchronous metastases in other organs.

Keywords: Bladder metastasis; Immune checkpoint inhibitor; Interval to relapse; Postoperative prognostic factor; Renal cell carcinoma.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Contrast-enhanced pelvic computed tomographic image showing a well-enhanced intraluminal bladder mass, consisting of components
Fig. 2
Fig. 2
Cystoscopic findings. Spherical, red and yellow, nodular tumor surrounded by vessels
Fig. 3
Fig. 3
Histopathological findings. Clear cell carcinoma in the bladder. Hematoxylin–eosin stain, reduced from 40×
Fig. 4
Fig. 4
Change of CT findings of the recurrence in the left renal bed over time. A Pretreatment, 33 × 31 × 34 mm3 in size (white arrow). B After 12 months of immune checkpoint inhibitor therapy, the lesion size had reduced to 12 × 15 × 13 mm3
See this image and copyright information in PMC

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References

    1. Motzer RJ, Tannir NM, McDermott DF, et al. Nivolumab plus ipilimumab versus sunitinib in advanced renal-cell carcinoma. N Engl J Med. 2018;378:1277–1290. doi: 10.1056/NEJMoa1712126. - DOI - PMC - PubMed
    1. Bates AW, Baithun SI. Secondary neoplasms of the bladder are histological mimics of nontransitional cell primary tumours: clinicopathological and histological features of 282 cases. Histopathology. 2000;36:32–40. doi: 10.1046/j.1365-2559.2000.00797.x. - DOI - PubMed
    1. Matsumoto K, Hayakawa N, Nakamura S, et al. Bladder metastasis from renal cell carcinoma: retrospective analysis of 65 reported cases. Clin Exp Metastasis. 2015;32:135–141. doi: 10.1007/s10585-015-9698-1. - DOI - PubMed
    1. Saitoh H. Distant metastasis of renal adenocarcinoma. Cancer. 1981;48:1487–1491. doi: 10.1002/1097-0142(19810915)48:6<1487::AID-CNCR2820480635>3.0.CO;2-9. - DOI - PubMed
    1. Tuna A, Tuna B, Seçil M, et al. Solitary synchronous metastasis to the urinary bladder from renal cell carcinoma: a case report. Turk J Pathol. 2010;26:82–84. doi: 10.5146/tjpath.2010.01001. - DOI