Massive Upper Gastrointestinal Bleeding Secondary to Duodenal Metastasis of Transitional Cell Carcinoma of the Urinary Bladder

Carlos H.F. Chan; Said A. Al-Busafi; Kevin A. Waschke

doi:10.1159/000327978

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Massive Upper Gastrointestinal Bleeding Secondary to Duodenal Metastasis of Transitional Cell Carcinoma of the Urinary Bladder

Journal article

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Massive Upper Gastrointestinal Bleeding Secondary to Duodenal Metastasis of Transitional Cell Carcinoma of the Urinary Bladder

Carlos H.F. Chan, Said A. Al-Busafi and Kevin A. Waschke

Case reports in gastroenterology, Vol.5(1), pp.246-248

04/20/2011

DOI: 10.1159/000327978

PMCID: PMC3094684

PMID: 21577372

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Abstract

Acute upper gastrointestinal (UGI) bleeding is a common problem in our clinical practice and is often due to peptic ulcer diseases. Occasionally, malignancy may be implicated in these situations. Here we report a rare case of UGI bleeding secondary to metastatic transitional cell carcinoma (TCC) of the urinary bladder. A 62-year-old man with a history of stage IIIb TCC of the urinary bladder presented with hematemesis. Endoscopy showed a large tumor in the second stage of the duodenum that occupied 40% of the duodenal circumference, over 7 cm in length. Biopsies revealed a poorly differentiated malignant neoplasm consistent with metastasis from urothelial carcinoma that was identical to the previous surgical specimen of the urinary bladder. He was treated with supportive therapy and intravenous proton pump inhibitor and was discharged home 2 weeks later. Two weeks after discharge, the patient returned to the hospital with a painful swelling of the floor of his mouth. Biopsy again showed the same cancer type. He had unremitting bleeding from his mouth requiring multiple transfusions and a course of palliative radiation therapy. He progressively deteriorated in his cardiopulmonary and neurological functions and expired with cardiopulmonary arrest one month later.

April 2011

Duodenal metastasis

Oropharyngeal metastasis

Published

Transitional cell carcinoma of the urinary bladder

Upper gastrointestinal bleeding

Details

Title: Subtitle: Massive Upper Gastrointestinal Bleeding Secondary to Duodenal Metastasis of Transitional Cell Carcinoma of the Urinary Bladder
Creators: Carlos H.F. Chan - McGill University Health Centre
Said A. Al-Busafi - Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, Que., Canada Division of Gastroenterology, Department of Medicine, McGill University Health Centre, Montreal, Que., Canada
Kevin A. Waschke - McGill University
Resource Type: Journal article
Publication Details: Case reports in gastroenterology, Vol.5(1), pp.246-248
DOI: 10.1159/000327978
PMID: 21577372
PMCID: PMC3094684
NLM abbreviation: Case Rep Gastroenterol
ISSN: 1662-0631
eISSN: 1662-0631
Publisher: S. Karger AG
Language: English
Date published: 04/20/2011
Academic Unit: Surgery; Radiation Oncology
Record Identifier: 9984312971002771

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