title: Percutaneous sequential bacillus Calmette-Guèrin and mitomycin C for panurothelial carcinomatosis.
abstract: A 59 year old male presented with a 4 month history of lower urinary tract symptoms. Exhaustive urological investigations revealed papillary tumors and carcinoma in situ extending from the prostatic urethra, throughout the bladder, up both ureters and into the renal pelves. Tumors were resected where possible and then bacillus Calmette-Guèrin (BCG) and mitomycin C (MMC) were infused sequentially through bilateral nephrostomy tubes for a total of six BCG and three MMC instillations. Follow up 1 month post treatment demonstrated a complete response which persisted for 2 years. Then there appeared a solitary papillomatous recurrence in the bladder which was successfully resected. Side effects were the occasional fever and BCG induced granulomatous prostatitis which slowly resolved. In conclusion, sequential BCG/MMC instillations were effective treatment for widespread panurothelial carcinomatosis.
authors.affiliation: Department of Surgery/Urology, "Tor Vergata" University, Rome.
authors.forename: Savino M
authors.initials: SM
authors.lastname: Di Stasi
authors.forename: Antonella
authors.initials: A
authors.lastname: Giannantoni
authors.forename: Robert L
authors.initials: RL
authors.lastname: Stephen
authors.forename: Luigi
authors.initials: L
authors.lastname: Storti
authors.forename: Francesco
authors.initials: F
authors.lastname: Attisani
authors.forename: Salvatore
authors.initials: S
authors.lastname: Sansalone
authors.forename: Guido
authors.initials: G
authors.lastname: Virgili
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D001500:BCG Vaccine / Q000008:administration & dosage*; D002277:Carcinoma / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D009403:Nephrostomy, Percutaneous; D014571:Urologic Neoplasms / Q000188:drug therapy*
chemical_list: D000276:Adjuvants, Immunologic; D000903:Antibiotics, Antineoplastic; D001500:BCG Vaccine; D016685:Mitomycin