Intracranial metastasis from primary transitional cell carcinoma of female urethra: case report & review of the literature.
BACKGROUND
Transitional cell carcinoma (TCC) of the female urethra is a rare urological malignancy, and intracranial metastasis of this cancer has not yet been reported in the literature. This review is intended to present a case of multiple intracranial metastasis in a female patient with a remote history of primary urethral TCC.


METHODS
A 49-year-old woman, presented with a prolapsed mass in urethral orifice that was diagnosed as primary urethral TCC with distant lung and multiple bone metastases. The patient subsequently underwent chemotherapy under various regimens. A year later, the patient developed headache and vomiting which as was found to be due to multiple intracranial metastasis. The patient underwent surgical resection of the largest lesion located on the cerebellum, and consecutively gamma knife radiosurgery was performed for other small-sized lesions. Pathological examination of the resected mass revealed a metastatic carcinoma from a known urethral TCC. Serial work-up of systemic metastasis revealed concomitant aggravation of lung, spleen, and liver metastasis. The patient died of lung complication 2 months after the diagnosis of brain metastasis.


CONCLUSIONS
To the best of our knowledge, this is the first reported case of cerebral metastasis from primary urethral TCC, with pathological confirmation. As shown in intracranial metastasis of other urinary tract carcinoma, this case occurred in the setting of uncontrolled systemic disease and led to dismal prognosis in spite of aggressive interventional modalities.
Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School, 160 Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do, 519-809, South Korea.
Kyung-Sub
KS
Moon
Shin
S
Jung
Kyung-Hwa
KH
Lee
Eu Chang
EC
Hwang
In-Young
IY
Kim
D001932:Brain Neoplasms / Q000556:secondary*; D002295:Carcinoma, Transitional Cell / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D014523:Urethral Neoplasms / Q000473:pathology*
Urology. 2006 Dec;68(6):1164-8
17141838
Urology. 1983 Jan;21(1):42-5
6823701
Acta Neurol Belg. 2009 Dec;109(4):322-5
20120215
No Shinkei Geka. 1989 Sep;17(9):883-6
2797376
J Clin Neurosci. 2007 Nov;14(11):1129-32
17434738
J Clin Oncol. 1987 Jul;5(7):1107-15
3037034
J Neurooncol. 2008 Jul;88(3):331-7
18392776
J Neurol. 2002 Oct;249(10):1357-69
12382150
Br J Urol. 1998 Dec;82(6):835-41
9883221
Cancer. 1973 Nov;32(5):1236-55
4757914
Int Urol Nephrol. 1987;19(4):423-7
3429167
Urology. 2003 Oct;62(4):749
14550465
J Neurooncol. 2010 Jan;96(1):33-43
19960230
Urology. 2006 Sep;68(3):673.e9-12
16979725
J Urol. 2002 Jun;167(6):2419-22
11992049
Surg Neurol. 2009 Feb;71(2):184-7; discussion 187
18295837
J Urol. 1996 Jan;155(1):111-4
7490804
J Neurooncol. 2002 Apr;57(2):141-5
12125975
Am J Clin Oncol. 1996 Oct;19(5):509-11
8823481
Urology. 1992 Jan;39(1):17-20
1728790