Low grade papillary transitional cell carcinoma pelvic recurrence masquerading as high grade invasive carcinoma, ten yea
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Open Access
Case report
Low grade papillary transitional cell carcinoma pelvic recurrence masquerading as high grade invasive carcinoma, ten years after radical cystectomy Pankaj P Dangle*1, Wenle Paul Wang2, Joel Mayerson3, Amir Mortazavi4 and Paul Monk4 Address: 1The James Cancer Hospital and Solove Research Institute, Ohio State University and Comprehensive Cancer Center, Columbus Ohio, 43210, USA, 2Department of Pathology, The Ohio State University, Columbus Ohio, 43210, USA, 3Department of Orthopedics, The Ohio State University, Columbus Ohio, 43210, USA and 4Department of Hematology and Oncology, The Ohio State University, Columbus Ohio, 43210, USA Email: Pankaj P Dangle* - [email protected]; Wenle Paul Wang - [email protected]; Joel Mayerson - [email protected]; Amir Mortazavi - [email protected]; Paul Monk - [email protected] * Corresponding author
Published: 30 September 2008 World Journal of Surgical Oncology 2008, 6:103
doi:10.1186/1477-7819-6-103
Received: 30 May 2008 Accepted: 30 September 2008
This article is available from: http://www.wjso.com/content/6/1/103 © 2008 Dangle et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Tumor recurrence following radical cystectomy for a low-grade superficial transitional cell carcinoma (TCC) is exceedingly uncommon and has not been reported previously. Case presentation: We describe a case of a young male presenting with anorexia, weight loss and a large, painful locally destructive pelvic recurrence, ten years after radical cystoprostatectomy. The pathology was consistent with a low-grade urothelial carcinoma. After an unsuccessful treatment with cisplatin-based chemotherapy, the patient underwent a curative intent hemipelvectomy with complete excision of tumor and is disease free at one year follow-up. Conclusion: A literature review related to this unusual presentation is reported and a surgical solutions over chemotherapy and radiotherapy is proposed.
Background
Case presentation
Low-grade papillary (Ta) urothelial carcinomas have the lowest risk of progression to invasive disease and death of all the superficial tumor types, with 50–70% recurrence rate after transurethral resection of bladder tumor (TURBT) and progression to invasive disease in 2.4–3.3% of cases [1]. In comparison, the high-grade disease managed with TURBT alone recurs in 80% of cases and becomes invasive in 50% [2]. We describe an unusual case of an aggressive low-grade papillary urothelial carcinoma recurrence ten years following radical cystectomy.
A 48 year old male with a long history of smoking presented with weight loss, anorexia and pelvic pain. He had a significant past history of a radical cystectomy ten years prior for a large multi-focal non-invasive, low-grade papillary
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