Transitional cell carcinoma (TCC) of bladder with metastasis to lung and bones

Bladder cancer is the 11th most common cancer and the fourth one in men around the world. The most prevalent sign is hematuria. Lung and bone are the most common metastasis sites. A new therapeutic plan for transitional cell carcinoma (TCC) with bone and lung metastasis is presented that next-generation sequencing (NGS) was also performed to assess predisposing genetic mutations.A 64-year-old man with hematuria and without the family history of tumor except for his brother hospitalized in Rasoul Akram Hospital in Tehran. Radiographic findings were thickening of his urinary bladder, and a primary diagnosis of grade 3 transitional cell carcinoma was made. Eight months later, he was suffering from urinary hesitancy and dripping but his laboratory tests were in the normal range. Radical nephrectomy of the left kidney was done in combination with chemotherapy. Lung metastasis was suddenly found by chest computed tomography (CT) scan and it was determined that there is a lung adenocarcinoma with perineural invasion and 4×3×2cm size so that the left upper lung lobectomy and six chemotherapy sessions. Fusion transcript of EML4-ALK was not detected in the NGS findings that it may not respond to crizotinib as a result chemotherapy with Paclitaxel 300mg and Carboplatin 600mg were done after pathologist confirmation. To check the chemotherapy efficacy, positron emission tomography (PET)-CT scan was done in two sessions and it showed pelvic bone metastasis. The treatment finished after two years and the patient has been followed by PET-CT scan.:The urotomography, biochemical analysis, and urine culture are diagnostic methods of urothelial carcinoma as well as radiography. An NGS has been shown that mutation in genes including FANCA, CSMD3, RB1, and HIF1A lead to urothelial cancer while in this case the EMLA4-ALK gene fusion was not detected.

کلیدواژه ها:

Transitional cell carcinoma ، lung adenocarcinoma ، next-generation sequencing ، metastasis ، hematuria