title: Case report: differential diagnosis of isolated iliac lymphadenopathy following Bacillus Calmette-Guérin treatment for high-risk superficial bladder cancer.
abstract: We report the unusual case of a patient with G3 pT1 transitional cell carcinoma (TCC) of the bladder, which was treated with repeated transurethral resection and maintenance intravesical Bacillus Calmette-Guérin (BCG) therapy. At 30 months follow-up, a symptomatic, solitary iliac lymph node mass was identified and biopsied. Histology demonstrated granulomatous tissue only, in the absence of any intravesical bladder tumour recurrence. Following 6 months of anti-tuberculous medication, the mass had progressed, and repeat biopsy revealed undifferentiated carcinoma (of a bladder primary). This is a rare case of metastatic superficial bladder cancer progression without local recurrence after BCG therapy. As such, it can be viewed as a diagnostic challenge.
authors: Department of Urology, The North Hampshire Hospital, Aldermaston Road, Basingstoke, Hampshire, RG24 9NA, UK. suzannebiers@hotmail.com
authors: Suzanne M
authors: SM
authors: Biers
authors: Aimee
authors: A
authors: Di Marco
authors: A Hugh
authors: AH
authors: Mostafid
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000283:Administration, Intravesical; D001500:BCG Vaccine / Q000627:therapeutic use*; D001706:Biopsy; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology; D003937:Diagnosis, Differential; D018450:Disease Progression; D006801:Humans; D007084:Iliac Vein; D008206:Lymphatic Diseases / Q000139:chemically induced* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine