Urothelial Carcinoma (UC) is one of the most frequent cancers worldwide. Transurethral Resection of Bladder Tumor (TURBT) is a standard treatment in the disease’s early stages, with bladder perforation being a possible and classical complication. However, extravesical tumor seeding resulting from perforation is a rare phenomenon. We hereby report the case of a 76-year-old man with a history of smoking diagnosed with high-grade T1 urothelial carcinoma. TURBT was performed and bladder perforation occurred during the procedure. Radical cystectomy after neoadjuvant chemotherapy failed to reveal an invasive tumor. However, the patient experienced peritoneal recurrence with liver metastasis 3 years following the operation. This case left physician wondering whether the bladder perforation and the resulting tumor seeding are the cause behind the late peritoneal recurrence of an early-stage urothelial carcinoma.
References
[1]
Richters, A., Aben, K.K.H. and Kiemeney, L.A.L.M. (2020) The Global Burden of Urinary Bladder Cancer: An Update. World Journal of Urology, 38, 1895-1904.
https://doi.org/10.1007/s00345-019-02984-4
[2]
Miyazaki, J. and Nishiyama, H. (2017) Epidemiology of Urothelial Carcinoma. International Journal of Urology, 24, 730-734. https://doi.org/10.1111/iju.13376
[3]
Burger, M., et al. (2012) Epidemiology and Risk Factors of Urothelial Bladder Cancer. European Urology, 63, 234-241.
[4]
Kirkali, Z., et al. (2005) Bladder Cancer: Epidemiology, Staging and Grading, and Diagnosis. Urology, 66, 4-34. https://doi.org/10.1016/j.urology.2005.07.062
[5]
Powles, T., et al. (2022) Bladder Cancer: ESMO Clinical Practice Guideline for Diagnosis, Treatment. Annals of Oncology, 33, 244-258.
https://doi.org/10.1016/j.annonc.2021.11.012
[6]
Traxer, O., Pasqui, F., Gattegno, B. and Pearle, M.S. (2004) Technique and Complications of Transurethral Surgery for Bladder Tumours. BJU International, 94, 492-496.
https://doi.org/10.1111/j.1464-410X.2004.04990.x
[7]
Lonati, C., et al. (2021) Bladder Perforation during Transurethral Resection of the Bladder: A Comprehensive Algorithm for Diagnosis, Management and Follow-Up. Minerva Urology and Nephrology, 74, 570-580.
https://doi.org/10.23736/S2724-6051.21.04436-0
[8]
Dick, A., Barnes, R., Hadley, H., Bergman, R.T., et al. (1980) Complications of Transurethral Resection of Bladder Tumors: Prevention, Recognition and Treatment. Journal of Urology, 124, 810-811. https://doi.org/10.1016/S0022-5347(17)55677-3
[9]
Skolarikos, A., Chrisofos, M., Ferakis, N. and Papatsoris, A. (2005) Does the Management of Bladder Perforation during Transurethral Resection of Superficial Bladder Tumors Predispose to Extravesical Tumor Recurrence? Journal of Urology, 173, 1908-1911. https://doi.org/10.1097/01.ju.0000158450.71497.ae
[10]
Golan, S., Baniel, J., Lask, D., Livne, P.M. and Yossepowitch, O. (2011) Transurethral Resection of Bladder Tumour Complicated by Perforation Requiring Open Surgical Repair—Clinical Characteristics and Oncological Outcomes. BJU International, 107, 1065-1068. https://doi.org/10.1111/j.1464-410X.2010.09696.x
[11]
Kim, J.H. and Yang, W.J. (2014) Delayed Spontaneous Perforation of Urinary Bladder with Intraperitoneal Seeding Following Radical Transurethral Resection of Invasive Urothelial Cancer: A Case Report. BMC Research Notes, 7, Article No. 167.
https://doi.org/10.1186/1756-0500-7-167
[12]
Bus, M.T., Cordeiro, E.R., Anastasiadis, A., Klioueva, N.M., De La Rosette, J.J. and De Reijke, T.M. (2012) Urothelial Carcinoma in both Adnexa Following Perforation during Transurethral Resection of a Non-Muscle-Invasive Bladder Tumor: A Case Report and Literature Review. Expert Review of Anticancer Therapy, 12, 1529-1536.
https://doi.org/10.1586/era.12.136
[13]
Lim, H., Khong, T., Ong, T., Roslani, A. and Ang, C. (2020) Case Report: A Rare Case of Extravesical, Extraperitoneal Metastasis after Transuretheral Resection of Urothelial Carcinoma. Urology Case Reports, 29, Article ID: 101017.
https://doi.org/10.1016/j.eucr.2019.101017
[14]
Corfitsen, M.T., Agdal, N. and Schrøder, M. (1989) Partial Obstruction of the Sigmoid Colon by Surgical Implantation. International Urology and Nephrology, 21, 479-483. https://doi.org/10.1007/BF02549585
[15]
Abaza, R., Keck, R.W. and Selman, S.H. (2006) Intraperitoneal Chemotherapy for the Prevention of Transitional Cell Carcinoma Implantation. The Journal of Urology, 175, 2317-2322. https://doi.org/10.1016/S0022-5347(06)00257-6
