title: [Atypical metastatic site of lung adenocarcinoma].
abstract: The case concerns a 40 years old smoker male, treated for an adenocarcinoma of the left upper lobe, metastatic in muscle extended to the right femur cortex. The patient had first a surgical excision of the mass of the thigh, an intramedullary femoral nailing, and six courses of chemotherapy (cisplatin-vinorelbine) with concurrent thoracic radiotherapy. This treatment led to disease stability. One year later, hematuria revealed a bladder tumor. Cystoscopy with biopsy concluded to an adenocarcinoma pulmonary origin. The PET-scanner showed an uptake of the bladder mass, a hypermetabolic right adrenal gland and subcutaneous left shoulder nodule. The patient had a partial cystectomy associated with enterocystoplasty and left ureteral reimplantation, plus excision of the subcutaneous nodule located in the left shoulder and a right adrenalectomy during the same time. All of the sites were metastasis from adenocarcinoma of pulmonary origin. A salvage chemotherapy was initiated. In the vast majority of cases, bladder metastasis as primary bladder tumours is revealed by hematuria, cystitis or sometimes vague pelvic pain. Our case is a very unusual bladder metastatic site from lung cancer. We will discuss the different procedures and the therapeutic strategies on the basis of the published data.
authors.affiliation: Service de pneumologie, nouvel hôpital Civil, Strasbourg, France.
authors.forename: L
authors.initials: L
authors.lastname: Sakhri
authors.forename: B
authors.initials: B
authors.lastname: Mennecier
authors.forename: D
authors.initials: D
authors.lastname: Jacqmin
authors.forename: A
authors.initials: A
authors.lastname: Di Marco
authors.forename: C
authors.initials: C
authors.lastname: Schumacher
authors.forename: M-P
authors.initials: MP
authors.lastname: Chenard
authors.forename: E
authors.initials: E
authors.lastname: Bergmann
authors.forename: E
authors.initials: E
authors.lastname: Quoix
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D000328:Adult; D001859:Bone Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary; D018450:Disease Progression; D005269:Femur; D006732:Horner Syndrome / Q000150:complications; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D019042:Muscle Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*