Solitary cerebellar metastasis from bladder cancer
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Department of Urology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Konrad Majcherczyk   

Oddział Kliniczny Urologii, Wydział Nauk Medycznych w Katowicach, Śląski Uniwersytet Medyczny w Katowicach, pl. Medyków 1, 41-200 Sosnowiec
Ann. Acad. Med. Siles. 2021;75:123-127
Brain metastases are quite rare in the course of bladder cancer and occur in only 1–7% of these patients. In most cases, cerebral metastases are secondary to visceral and lymph node metastases. A single cerebellar metastasis as the primary manifestation of transitional cell carcinoma (TCC) has only been reported in few cases. A 55-year-old man presented to the hospital with persistent headaches, accompanied by nausea and balance disturbance lasting for three weeks. Computed tomography (CT) of the head revealed a nodular lesion measuring 28 x 24 x 22 mm in diameter, located in the cerebellar vermis. Subsequently, a CT scan conducted of the chest, abdominal cavity and lesser pelvis revealed a tumor in the urinary bladder with concomitant right hydronephrosis. No lymphadenopathy nor signs of other metastases were found. Craniotomy with complete tumor resection and external ventricular drainage was performed. The patient underwent transurethral electroresection of the bladder tumor involving the right part of the bladder trigone with the right ureteral orifice and the right bladder wall. The histopathological and immunohistochemical examination of both the cerebellar and bladder tumors confirmed high grade muscle invasive bladder cancer (T2, HG). Based on these findings, the patient was diagnosed with cerebellar metastasis from primary bladder cancer. The patient did not consent to the proposed cystectomy and was transferred to the oncology department where he was qualified for brain and pelvic radiotherapy and subsequent systemic chemotherapy. This case is an example that bladder cancer (stage T2) may develop without urologic symptoms.
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Wojciechowska U., Didkowska J., Zatoński W. Cancer in Poland in 2012. Centrum Onkologii — Instytut im. M. Skłodowskiej-Curie. Warsaw 2014, p. 51–113.
Jabłonowski Z. Urinary bladder cancer – epidemiology, diagnostics and treatment in XXIst century [Article in Polish]. Folia Med. Lodz. 2013; 40(1): 31–52.
Burger M., Catto J.W., Dalbagni G., Grossman H.B., Herr H., Karakiewicz P. et al. Epidemiology and risk factors of urothelial bladder cancer. Eur. Urol. 2013; 63(2): 234–241, doi: 10.1016/j.eururo.2012.07.033.
Ferlay J., Shin H.R., Bray F., Forman D., Mathers C., Parkin D.M. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int. J. Cancer 2010; 127(12): 2893–2917, doi: 10.1002/ijc.25516.
Stenzl A., Cowan N.C., De Santis M., Kuczyk M.A., Merseburger A.S., Ribal M.J. et al. Treatment of muscle-invasive and metastatic bladder cancer: update of the EAU guidelines. Eur. Urol. 2011; 59(6): 1009–1018, doi: 10.1016/j.eururo.2011.03.023.
Vikram R., Sandler C.M., Ng C.S. Imaging and staging of transitional cell carcinoma: part 1, lower urinary tract. AJR Am. J. Roentgenol. 2009; 192(6): 1481–1487, doi: 10.2214/AJR.08.1318.
Urinary bladder. (Urological tumours). In: TNM classification of malignant tumours. L.H. Sobin, M.K. Gospodarowicz, C. Wittekind [ed.]. 7th ed. Wiley-Blackwell. New York 2009, p. 262–265.
Klos K.J., O’Neill B.P. Brain metastases. Neurologist 2004; 10(1): 31–46, doi: 10.1097/01.nrl.0000106922.83090.71.
Shinagare A.B., Ramaiya N.H., Jagannathan J.P., Fennessy F.M., Taplin M.E., Van den Abbeele A.D. Metastatic pattern of bladder cancer: correlation with the characteristics of the primary tumor. AJR Am. J. Roentgenol. 2011; 196(1): 117–122, doi: 10.2214/AJR.10.5036.
Sarmiento J.M., Wi M.S., Piao Z., Stiner E.S. Solitary cerebral metastasis from transitional cell carcinoma after a 14-year remission of urinary bladder cancer treated with gemcitabine: Case report and literature review. Surg. Neurol. Int. 2012; 3: 82, doi: 10.4103/2152-7806.99172.
Shamdas G.J., McLaren G.D., Grimm T., Everson L.K. Solitary cerebellar metastasis from transitional cell carcinoma of bladder. Urology 1992; 40(1): 50–53, doi: 10.1016/0090-4295(92)90436-z.
Davies B.J., Bastacky S., Chung S.Y. Large cerebellar lesion as original manifestation of transitional cell carcinoma of the bladder. Urology 2003; 62(4): 749, doi: 10.1016/s0090-4295(03)00662-9.
Kobayashi T., Ogura K., Nishizawa K., Ono M., Ueno Y., Miyake H., Ide Y. Clinically isolated cerebellar metastasis of renal pelvic urothelial cancer. Int. J. Urol. 2004; 11(1): 47–49, doi: 10.1111/j.1442-2042.2004.00735.x.
Perlmutter A.E., Zaitoon A., Sparks S.S., Zaslau S., Zaitoon M. Isolated cerebellar metastasis in a patient with organ-confined, lymph node negative bladder cancer. W. V. Med. J. 2006; 102(5): 14–15.
D’Souza N., Khan M.J., Robinson S., Motiwala H. A rare and unusual case of isolated cerebellar metastasis from a non-muscle invasive transitional cell carcinoma of bladder. JRSM Short Rep. 2011; 2(6): 50, doi: 10.1258/shorts.2011.011014.
Vaa B., Kohli M., Price K.A., Swetz K.M. Solitary cystic cerebellar metastasis in a patient with invasive transitional cell carcinoma of the bladder. BMJ Case Rep. 2014; 2014: bcr2013200137, doi: 10.1136/bcr-2013-200137.
Tsugu A., Yoshiyama M., Matsumae M. Brain metastasis from large cell neuroendocrine carcinoma of the urinary bladder. Surg. Neurol. Int. 2011; 2: 84, doi: 10.4103/2152-7806.82250.
MacVicar A.D. Bladder cancer staging. BJU Int. 2000; 86 Suppl 1: 111–122, doi: 10.1046/j.1464-410x.2000.00589.x.
Hofer C., Kübler H., Hartung R., Breul J., Avril N. Diagnosis and monitoring of urological tumors using positron emission tomography. Eur. Urol. 2001; 40(5): 481–487, doi: 10.1159/000049823.
Barentsz J.O., Jager G.J., Witjes J.A. MR imaging of the urinary bladder. Magn. Reson. Imaging Clin. N. Am. 2000; 8(4): 853–867.
Bachor R., Kotzerke J., Reske S.N., Hautmann R. Lymph node staging of bladder neck carcinoma with positron emission tomography [Article in German]. Urologe A 1999; 38(1): 46–50, doi: 10.1007/s001200050244.
Mahmoud-Ahmed A.S., Suh J.H., Kupelian P.A., Klein E.A., Peereboom D.M., Dreicer R., Barnett G.H. Brain metastases from bladder carcinoma: presentation, treatment and survival. J. Urol. 2002; 167(6): 2419–2422.
Rosenstein M., Wallner K., Scher H., Sternberg C.N. Treatment of brain metastases from bladder cancer. J. Urol. 1993; 149(3): 480–483, doi: 10.1016/s0022-5347(17)36123-2.
Anderson R.S., el-Mahdi A.M., Kuban D.A., Higgins E.M. Brain metastases from transitional cell carcinoma of urinary bladder. Urology 1992; 39(1): 17–20, doi: 10.1016/0090-4295(92)90034-t.
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