Maria Giuseppa Vitale*, Marco Oltrecolli, Stefania Pipitone, Eleonora Molinaro, Cinzia Baldessari, Roberto Sabbatini, Massimo Dominici and Cecilia Nasso
Department of Oncology and Hematology, Modena University Hospital, ItalyFulltext PDF
Renal pelvis and ureter‘s tumors constitute upper urinary tract tumors, whose histological subtype is urothelial carcinoma, that occurs more frequently in bladder. The pattern of metastases is similar between upper urinary tract and bladder urothelial carcinoma: Lymph nodes, liver, bone and lung. Here we describe a case report where a 43-years-old man affected by urothelial carcinoma of ureter underwent right nephroureterectomy and retroperitoneal lymph nodes dissection and then it was administered adjuvant chemotherapy (4 cycles of cisplatin/gemcitabine). Then, during his clinical and radiological follow-up, some uncommon sites of metastases were found, such as stomach, peritoneum, left axillary, right and left supraclavicular lymph node. At the end of five cycles of first-line chemotherapy, he developed symptoms connected to Leptomeningeal Carcinomatosis (LMC), which is absolutely an atypical site of relapse for this kind of tumor. Patient was treated with intrathecal methotrexate 12 mg once weekly and second-line therapy with Pembrolizumab 200 mg flat dose for four cycles. In literature we have found only other two case reports which describe LMC in urothelial carcinoma of upper urinary tract and no patient affected by this tumor treated with systemic immunotherapy and intrathecal chemotherapy for LMC. Our patient died three months after the LMC diagnosis, supporting the fact that the prognosis for this site of metastasis is poor.
Urothelial carcinoma; Leptomeningeal carcinomatosis; Metastatic
Vitale MG, Oltrecolli M, Pipitone S, Molinaro E, Baldessari C, Sabbatini R, et al. Unusual Metastatic Localizations of Urothelial Carcinoma of Ureter in Young Male Patient. Ann Clin Case Rep. 2022; 7: 2138..