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Non-Muscle Invasive Papillary Urothelial Carcinoma Metastatic to the Mandible
Journal article   Open access   Peer reviewed

Non-Muscle Invasive Papillary Urothelial Carcinoma Metastatic to the Mandible

Noah Frydenlund, Yousef Zakharia, Rohan Garje, Laila Dahmoush and Michael A. O'Donnell
JIM - high impact case reports, Vol.6, pp.2324709618806332-2324709618806332
10/16/2018
DOI: 10.1177/2324709618806332
PMCID: PMC6194919
PMID: 30349834
url
https://doi.org/10.1177/2324709618806332View
Published (Version of record) Open Access

Abstract

Urothelial carcinoma, the most common histologic subtype of bladder cancer in the United States, most frequently presents as non-muscle invasive disease. Initially, therapy involves transurethral endoscopic resection and subsequent intravesical therapies with extended surveillance for high-risk disease. Even with the best treatments, recurrence and progression can occur. However, metastasis of non-muscle invasive bladder cancer to distant sites without evidence of progression or regional metastasis is rare. In this article, we present the case of a patient with high-grade papillary urothelial carcinoma who developed an unusual metastasis to the mandible, confirmed by GATA-3 immunostaining, over 4 years after initial transurethral resection. Prior to the development of metastatic disease, this patient had no evidence of local recurrence during maintenance Bacillus Calmette-Guerin intravesical therapy and concurrent surveillance. Positron emission tomographycomputed tomography taken after presentation with mandibular metastasis did not show any evidence of regional metastasis. This case highlights an unusual location for distant metastasis of urothelial carcinoma occurring in a patient without evidence of muscle invasive disease or regional metastasis. We additionally highlight the utility of GATA-3 immunostaining in identifying urothelial carcinoma histologically.
General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology

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