Peritonitis carcinomatosa in a patient with recurrent "superficial" bladder cancer treated with cystectomy and nephroureterectomy.
We report on a 45-year-old woman treated with cystectomy after failure of bacille Calmette-Guérin therapy for superficial transitional cell carcinoma. After 9 months, left-sided nephroureterectomy was performed for recurrence in the left ureter. The pathologic examination revealed carcinoma in situ and no tumor-positive lymph nodes (pTisN0Mx). At 2.5 years later, she complained of abdominal distension and pain. She underwent bilateral removal of the ovaries, infracolic omentectomy, and liver biopsy because of suspicious lesions on the liver. Pathologic examination revealed extensive peritoneal spread of transitional cell carcinoma. The seeding potential of high-grade urothelial cancer is well known; however, we found no clear explanation for the peritoneal spread of tumor cells in this patient that occurred years after the surgical procedures.
de Vries
R R
RR
Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Bex
A
A
Horenblas
S
S
D002295:Carcinoma, Transitional Cell / Q000556:secondary* / Q000601:surgery*; D015653:Cystectomy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009392:Nephrectomy; D010534:Peritoneal Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery*; D010538:Peritonitis / Q000209:etiology; D014513:Ureter / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*