title: Unusual presentation of direct intraperitoneal metastases complicated with massive ascites from plasmacytoid variant of bladder cancer and adenocarcinoma of colon: A case report and literature review.
abstract: BACKGROUND
  Plasmacytoid urothelial carcinoma (PUC) is a distinct variant of urinary bladder cancer, with a high propensity for invasion and poor prognosis. These tumors occur most commonly in male patients with the age of reported cases ranging from 46 to 87 years.
  
  
  METHODS
  We present a case of a 74-year-old male patient having massive ascites and bilateral lower leg edema. Colonoscopy showed a 3-cm lesion in the sigmoid colon and an edematous nonpapillary tumor was found by cystoscopy in the bladder. Histopathology analysis of the biopsies showed adenocarcinoma of colon and PUC of bladder. The diagnosis of PUC with peritoneal carcinomatosis was then confirmed by immunohistochemical stain.
  
  
  CONCLUSIONS
  The diagnostic dilemmas of the unusual variant of urothelial malignancy, the origin of peritoneal metastasis, and its clinical impact are discussed in the present case.
authors.affiliation: Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center Department of Surgery, Taoyuan Armed Forces General Hospital, Taipei, Taiwan, ROC.
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Shao
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Kao
authors.forename: Shou-Hung
authors.initials: SH
authors.lastname: Tang
authors.forename: Tai-Lung
authors.initials: TL
authors.lastname: Cha
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Tsao
authors.forename: En
authors.initials: E
authors.lastname: Meng
authors.forename: Dah-Shyong
authors.initials: DS
authors.lastname: Yu
authors.forename: Guang-Huan
authors.initials: GH
authors.lastname: Sun
authors.forename: Sheng-Tang
authors.initials: ST
authors.lastname: Wu
mesh_terms: D000368:Aged; D001201:Ascites / Q000209:etiology* / Q000473:pathology; D002277:Carcinoma / Q000150:complications* / Q000556:secondary; D003110:Colonic Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D009378:Neoplasms, Multiple Primary / Q000150:complications*; D010534:Peritoneal Neoplasms / Q000150:complications / Q000556:secondary*; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000473:pathology