RESUMEN
BACKGROUND: The studies IMvigor 210 cohort 2 and IMvigor211 evaluated the efficacy of atezolizumab in patients with locally advanced or metastatic urothelial cancer (mUC) upon progression to platinum-based chemotherapy worldwide. Yet, the real impact of this drug in specific geographical regions is unknown. MATERIALS AND METHODS: We combined individual-level data from the 131 patients recruited in Spain from IMvigor210 cohort 2 and IMvigor211 in a pooled analysis. Efficacy and safety outcomes were assessed in the overall study population and according to PD-L1 expression on tumour-infiltrating immune cells. RESULTS: Full data were available for 127 patients; 74 (58%) received atezolizumab and 53 (42%) chemotherapy. Atezolizumab patients had a numerically superior median overall survival although not reaching statistical significance (9.2 months vs 7.7 months). No statistically significant differences between arms were observed in overall response rates (20.3% vs 37.0%) or progression-free survival (2.1 months vs 5.3 months). Nonetheless, median duration of response was superior for the immunotherapy arm (non-reached vs 6.4 months; p = 0.005). Additionally, among the responders, the 12-month survival rates seemed to favour atezolizumab (66.7% vs 19.9%). When efficacy was analyzed based on PD-L1 expression status, no significant differences were found. Treatment-related adverse events of any grade occurred more frequently in the chemotherapy arm [46/57 (81%) vs 44/74 (59%)]. CONCLUSION: Patients who achieved an objective response on atezolizumab presented a longer median duration of response and numerically superior 12 month survival rates when compared with chemotherapy responders along with a more favorable safety profile. PD-L1 expression did not discriminate patients who might benefit from atezolizumab.
Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Antineoplásicos/uso terapéutico , Carcinoma de Células Transicionales/tratamiento farmacológico , Neoplasias Ureterales/tratamiento farmacológico , Neoplasias Uretrales/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales Humanizados/efectos adversos , Antineoplásicos/efectos adversos , Antígeno B7-H1/metabolismo , Carcinoma de Células Transicionales/metabolismo , Carcinoma de Células Transicionales/mortalidad , Carcinoma de Células Transicionales/secundario , Estudios de Cohortes , Femenino , Humanos , Linfocitos Infiltrantes de Tumor/metabolismo , Masculino , Persona de Mediana Edad , Supervivencia sin Progresión , España , Tasa de Supervivencia , Resultado del Tratamiento , Neoplasias Ureterales/metabolismo , Neoplasias Ureterales/mortalidad , Neoplasias Ureterales/patología , Neoplasias Uretrales/metabolismo , Neoplasias Uretrales/mortalidad , Neoplasias Uretrales/patología , Neoplasias de la Vejiga Urinaria/metabolismo , Neoplasias de la Vejiga Urinaria/mortalidad , Neoplasias de la Vejiga Urinaria/patologíaAsunto(s)
Humanos , Femenino , Persona de Mediana Edad , Carcinoma de Células Transicionales/cirugía , Carcinoma de Células Transicionales/tratamiento farmacológico , Carcinoma de Células Transicionales/secundario , Carcinoma de Células Transicionales/diagnóstico por imagen , Neoplasias Ováricas/cirugía , Neoplasias Ováricas/secundario , Neoplasias Ováricas/diagnóstico por imagen , Neoplasias de la Vejiga Urinaria , Tomografía Computarizada por Rayos X , LaparotomíaRESUMEN
PURPOSE: To detect the expression level and significance of SOX10 in human bladder cancer. METHODS: Immunohistochemical analyses were performed to assess SOX10 protein level using a bladder cancer tissue microarray (including 59 spots of cancer tissues and 46 spots of paired normal tissues) and 31 specimens and to define the relationship between SOX10 and clinicopathological bladder cancer characteristics in patients. SOX10 protein and mRNA levels in bladder cancer cell lines (T24, 5637, BIU87, EJ) and transitional cell papilloma cell line (RT4) were tested by western blotting and quantitative real-time PCR (q-PCR), respectively. Cell Counting Kit-8 (CCK-8) and colony formation assays were performed to investigate bladder cancer cell proliferation after SOX10 knockdown. The effect of SOX10 on cell migration and invasion was analyzed by Transwell and Matrigel assays. Kaplan-Meier survival curves and Cox regression analyses were used to evaluate SOX10 prognostic significance for bladder cancer patients. The mechanisms by which SOX10 promote bladder cancer progression were examined by western blotting. RESULTS: SOX10 protein was upregulated in 74.4% of bladder cancer tissues compared with adjacent normal tissues (32.6%). SOX10 protein was also upregulated in malignant cell lines. In addition, high SOX10 expression was related with clinical stage (P = 0.008), T stage (P = 0.004), histological grade (P = 0.002) and lymph node metastasis (P = 0.006). Kaplan-Meier survival curves and Cox regression analyses showed that SOX10 functioned as an independent prognostic factor for overall survival. SOX10 knockdown in bladder cancer cells significantly impacted proliferation, migration and invasion, and SOX10 might promote bladder cancer progression by altering ß-catenin and Met expression. CONCLUSION: SOX10 was over-expressed in bladder cancer and promoted malignant bladder cancer cell behaviors. SOX10 has potential as a molecular target for bladder cancer treatment.
Asunto(s)
Biomarcadores de Tumor/metabolismo , Carcinoma de Células Transicionales/secundario , Regulación Neoplásica de la Expresión Génica , Factores de Transcripción SOXE/metabolismo , Neoplasias de la Vejiga Urinaria/patología , Anciano , Biomarcadores de Tumor/genética , Carcinoma de Células Transicionales/genética , Carcinoma de Células Transicionales/metabolismo , Estudios de Casos y Controles , Movimiento Celular , Proliferación Celular , Femenino , Estudios de Seguimiento , Humanos , Metástasis Linfática , Masculino , Pronóstico , Factores de Transcripción SOXE/genética , Tasa de Supervivencia , Células Tumorales Cultivadas , Neoplasias de la Vejiga Urinaria/genética , Neoplasias de la Vejiga Urinaria/metabolismoRESUMEN
The goal of this article is to provide recommendations for the diagnosis and treatment of muscle-invasive and metastatic bladder cancer. The diagnosis of muscle-invasive bladder cancer is made by pathologic evaluation after transurethral resection. Recently, a molecular classification has been proposed. Staging of muscle-invasive bladder cancer must be done by computed tomography scans of the chest, abdomen and pelvis and classified on the basis of UICC system. Radical cystectomy and lymph node dissection are the treatment of choice. In muscle-invasive bladder cancer, neoadjuvant chemotherapy should be recommended in patients with good performance status and no renal function impairment. Although there is insufficient evidence for use of adjuvant chemotherapy, its use must be considered when neoadjuvant therapy had not been administered in high-risk patients. Multimodality bladder-preserving treatment in localized disease is an alternative in selected and compliant patients for whom cystectomy is not considered for clinical or personal reasons. In metastatic disease, the first-line treatment for patients must be based on cisplatin-containing combination. Vinflunine is the only drug approved for use in second line in Europe. Recently, immunotherapy treatment has demonstrated activity in this setting.
Asunto(s)
Carcinoma de Células Transicionales/diagnóstico , Carcinoma de Células Transicionales/terapia , Músculo Esquelético/patología , Guías de Práctica Clínica como Asunto , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/terapia , Carcinoma de Células Transicionales/patología , Carcinoma de Células Transicionales/secundario , Humanos , Invasividad Neoplásica , España , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
ABSTRACT Purpose: To determine the effect of diagnostic ureteroscopy on intravesical recurrence in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). Materials and Methods: We conducted a retrospective analysis of 664 patients who were treated with RNU for UTUC from June 2000 to December 2011, excluding those who had concomitant/prior bladder tumors. Of the 664 patients, 81 underwent diagnostic ureteroscopy (URS). We analyzed the impact of diagnostic ureteroscopy on intravesical recurrence (IVR) using the Kaplan-Meier method. Univariate and multivariate analyses were used to determine the independent risk factors. Results: The median follow-up time was 48 months (interquartile range (IQR): 31-77 months). Patients who underwent ureteroscopy were more likely to have a small (p<0.01), early-staged (p=0.019), multifocality (p=0.035) and ureteral tumor (p<0.001). IVR occurred in 223 patients during follow-up within a median of 17 months (IQR: 7-33). Patients without preoperative ureteroscopy have a statistically significant better 2-year (79.3%±0.02 versus 71.4%±0.02, p<0.001) and 5-year intravesical recurrence-free survival rates (64.9%±0.05 versus 44.3%±0.06, p<0.001) than patients who underwent ureteroscopy. In multivariate analysis, the diagnostic ureteroscopy (p=0.006), multiple tumors (p=0.001), tumor size <3cm (p=0.008), low-grade (p=0.022) and pN0 stage tumor (p=0.045) were independent predictors of IVR. Conclusions: Diagnostic ureteroscopy is independently associated with intravesical recurrence after radical nephroureterectomy.
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Neoplasias Ureterales/patología , Neoplasias de la Vejiga Urinaria/patología , Neoplasias Urológicas/patología , Ureteroscopía/métodos , Recurrencia Local de Neoplasia/patología , Nefrectomía/métodos , Uréter/patología , Neoplasias Ureterales/cirugía , Neoplasias de la Vejiga Urinaria/cirugía , Carcinoma de Células Transicionales/cirugía , Carcinoma de Células Transicionales/secundario , Estudios de Seguimiento , Neoplasias Urológicas/cirugía , Supervivencia sin Enfermedad , Clasificación del Tumor , Persona de Mediana EdadRESUMEN
There are very few biomarkers used to diagnose bladder cancer and no clinically approved biomarkers for prediction or prognostication of this disease. All currently available biomarkers are based on urine tests, and thus, they may not be applicable to patients with extravesical tumors. Biopsy of metastatic sites requires an invasive procedure, whereas serum-based markers, which can be easily obtained and serially measured, thus have obvious merit. These deficiencies may be overcome with advances in genome sequencing, identification of circulating tumor cells, and RNA-, protein-, and DNA-based biomarkers. Here, progress in circulating biomarkers in both superficial and invasive bladder cancer is described.
Asunto(s)
Biomarcadores de Tumor/sangre , Carcinoma de Células Transicionales/sangre , Neoplasias Urológicas/sangre , Antineoplásicos/uso terapéutico , Biomarcadores de Tumor/orina , Carcinoma de Células Transicionales/tratamiento farmacológico , Carcinoma de Células Transicionales/patología , Carcinoma de Células Transicionales/secundario , Separación Celular/métodos , ADN de Neoplasias/sangre , ADN de Neoplasias/orina , Progresión de la Enfermedad , Monitoreo de Drogas , Predicción , Humanos , Mutación , Invasividad Neoplásica , Proteínas de Neoplasias/sangre , Proteínas de Neoplasias/genética , Células Neoplásicas Circulantes/química , ARN Neoplásico/sangre , Neoplasias Urológicas/tratamiento farmacológico , Neoplasias Urológicas/patologíaRESUMEN
PURPOSE: To determine the effect of diagnostic ureteroscopy on intravesical recurrence in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterec¬tomy (RNU). MATERIALS AND METHODS: We conducted a retrospective analysis of 664 patients who were treated with RNU for UTUC from June 2000 to December 2011, excluding those who had concomitant/prior bladder tumors. Of the 664 patients, 81 underwent di¬agnostic ureteroscopy (URS). We analyzed the impact of diagnostic ureteroscopy on intravesical recurrence (IVR) using the Kaplan-Meier method. Univariate and multi¬variate analyses were used to determine the independent risk factors. RESULTS: The median follow-up time was 48 months (interquartile range (IQR): 31- 77 months). Patients who underwent ureteroscopy were more likely to have a small (p<0.01), early-staged (p=0.019), multifocality (p=0.035) and ureteral tumor (p<0.001). IVR occurred in 223 patients during follow-up within a median of 17 months (IQR: 7-33). Patients without preoperative ureteroscopy have a statistically significant better 2-year (79.3%±0.02 versus 71.4%±0.02, p<0.001) and 5-year intravesical recurrence-free survival rates (64.9%±0.05 versus 44.3%±0.06, p<0.001) than patients who un¬derwent ureteroscopy. In multivariate analysis, the diagnostic ureteroscopy (p=0.006), multiple tumors (p=0.001), tumor size <3cm (p=0.008), low-grade (p=0.022) and pN0 stage tumor (p=0.045) were independent predictors of IVR. CONCLUSIONS: Diagnostic ureteroscopy is independently associated with intravesical re¬currence after radical nephroureterectomy.
Asunto(s)
Recurrencia Local de Neoplasia/patología , Nefrectomía/métodos , Neoplasias Ureterales/patología , Ureteroscopía/métodos , Neoplasias de la Vejiga Urinaria/patología , Neoplasias Urológicas/patología , Anciano , Carcinoma de Células Transicionales/secundario , Carcinoma de Células Transicionales/cirugía , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Uréter/patología , Neoplasias Ureterales/cirugía , Neoplasias de la Vejiga Urinaria/cirugía , Neoplasias Urológicas/cirugíaRESUMEN
OBJECTIVE: Ulceration is common in bladder tumors, but its prognostic role, although intuitive, is not established. We aim to explore the presence of gross ulceration and its relationship with other morphological and biological features classically associated with extravesical disease, in patients submitted to radical cystectomy. METHODS: Tumor size and morphology were noted on 101 cystectomy patients (2000-2010). Papillary, exophytic, and vegetant tumors were grouped as "papillary" and solid/nodular, ulcerated and infiltrative as "nonpapillary." Ulceration was noted grossly in every case as a binary parameter, regardless of morphology. Immunohistochemistry was performed for hypoxia (hypoxia-inducible factor-1α and vascular endothelial growth factor), and cell cycle proteins (pRb, p53, and cyclin D1). RESULTS: Mean age was 66.7 year, male:female ratio was 2:1, 20 patients received bacillus Calmette-Guerin and 10 neoadjuvant chemotherapy. Upstaging rate was 56.4%. Ulcerated lesions presented mostly as nonpapillary and nonorgan confined (nOC), whereas nonulcerated tumors were often papillary and organ confined (OC). Tumor size was smaller in nonpapillary tumors (P = 0.002), but did not associate with altered hypoxia or cell cycle expressions. pRb and cyclin D1 loss and p53 overexpression were more frequent in ulcerated and non-OC tumors as did the phenotype vascular endothelial growth factor-negative/hypoxia-inducible factor-1α-low (P<0.001). On a multivariate model, ulceration was an independent predictor of non-OC and extravesical disease. CONCLUSION: Patients with ulcerated tumors were often staged with extravesical disease, independent of other morphologic and biological features known to affect prognosis. Prospective studies are needed to confirm the predictive value of tumor ulceration at cystoscopy, which could improve patient stratification for neoadjuvant chemotherapy.
Asunto(s)
Carcinoma de Células Transicionales/secundario , Cistectomía , Úlcera/etiología , Neoplasias de la Vejiga Urinaria/patología , Anciano , Antineoplásicos/uso terapéutico , Vacuna BCG/uso terapéutico , Carcinoma de Células Transicionales/química , Carcinoma de Células Transicionales/complicaciones , Carcinoma de Células Transicionales/terapia , Ciclo Celular , Hipoxia de la Célula , Terapia Combinada , Femenino , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/análisis , Escisión del Ganglio Linfático , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante , Proteínas de Neoplasias/análisis , Carga Tumoral , Úlcera/patología , Neoplasias de la Vejiga Urinaria/química , Neoplasias de la Vejiga Urinaria/complicaciones , Neoplasias de la Vejiga Urinaria/terapia , Factor A de Crecimiento Endotelial Vascular/análisisRESUMEN
Neurodegenerative diseases represent a heterogeneous group of neurological conditions primarily involving dementia, motor neuron disease and movement disorders. They are mostly related to different pathophysiological processes, notably in family forms in which the clinical and genetic heterogeneity are lush. In the last decade, much knowledge has been acumulated about the genetics of neurodegenerative diseases, making it essential in cases of motor neuron disease and frontotemporal dementia the repeat expansions of C9orf72 gene. This review analyzes the main clinical, radiological and genetic aspects of the phenotypes related to the hexanucleotide repeat expansions (GGGGCC) of C9orf72 gene. Future studies will aim to further characterize the neuropsychological, imaging and pathological aspects of the extra-motor features of motor neuron disease, and will help to provide a new classification system that is both clinically and biologically relevant.
As doenças neurodegenerativas representam um grupo heterogêneo de condições neurológicas envolvendo fundamentalmente síndromes demenciais, doenças do neurônio motor e distúrbios de movimento. Relacionam-se, em sua maioria, a processos fisiopatológicos distintos, destacadamente nas formas familiares em que a heterogeneidade clínica e genética são exuberantes. Na última década, muito conhecimento se acumulou a respeito da genética das doenças neurodegenerativas, tornando-se bastante importante nos casos de doenças do neurônio motor e de demência frontotemporal as expansões de repetições do gene C9orf72. Esta revisão aborda os principais aspectos clínicos, radiológicos e genéticos relativos aos fenótipos relacionados à expansão de repetição do hexanucleotídeo (GGGGCC) no gene C9orf72. Estudos futuros vão objetivar a caracterização dos aspectos neuropsicológicos, de imagem e patológicos dos achados extra-motores da doença do neurônio motor e ajudarão a fornecer um novo sistema de classificação relevante em termos clínicos e biológicos.
Asunto(s)
Femenino , Humanos , Masculino , Carcinoma de Células Transicionales/secundario , Carcinoma de Células Transicionales/cirugía , Pelvis Renal , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Escisión del Ganglio Linfático/métodos , Neoplasias Ureterales/secundario , Neoplasias Ureterales/cirugíaRESUMEN
A 59-year-old man presented with persistent skin rash found to be cutaneous metastasis from micropapillary urothelial carcinoma status post right radical nephroureterectomy and adjuvant chemotherapy. The skin metastasis appeared 2 months after postchemotherapy imaging demonstrated complete radiographic response. Cutaneous metastases from primary genitourinary malignancies are very rare clinical entities associated with poor prognosis. Cutaneous metastases do not have distinctive gross appearance and are often misdiagnosed as common dermatologic disorders. It is imperative that urologists have high index of suspicion for metastasis in patients with persistent skin rash in the setting of advanced genitourinary malignancies.
Asunto(s)
Carcinoma de Células Transicionales/secundario , Neoplasias Cutáneas/secundario , Neoplasias Urológicas/patología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Metastases to the stomach from an extra-digestive neoplasm are an unusual event, identified in less than 2% of cancer patients at autopsy (between 1.7% to 5%). The stomach may be involved by hematogenous spread from a distant primary tumor (most commonly lung, breast and melanoma). Tumors of neighboring organs, such as esophagus, pancreas and gallbladder, may reach the stomach by continuity or by lymphatic-hematogenous spread. Endoscopic routine studies with biopsies have improved the diagnosis of this pathology. Nevertheless, in some cases the histologic study is a false negative because the neoplasia can be placed in the deepest layers of the stomach. We report the case of a 56-year-old man who presented a gastric metastasis of a high gradeuro thelial carcinoma of urinary bladder and we review the literature.
Asunto(s)
Carcinoma de Células Transicionales/secundario , Neoplasias Gástricas/secundario , Neoplasias de la Vejiga Urinaria/patología , Carcinoma de Células Transicionales/patología , Resultado Fatal , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Gástricas/patologíaRESUMEN
Metastases to the stomach from an extra-digestive neoplasm are an unusual event, identified in less than 2
of cancer patients at autopsy (between 1.7
to 5
). The stomach may be involved by hematogenous spread from a distant primary tumor (most commonly lung, breast and melanoma). Tumors of neighboring organs, such as esophagus, pancreas and gallbladder, may reach the stomach by continuity or by lymphatic-hematogenous spread. Endoscopic routine studies with biopsies have improved the diagnosis of this pathology. Nevertheless, in some cases the histologic study is a false negative because the neoplasia can be placed in the deepest layers of the stomach. We report the case of a 56-year-old man who presented a gastric metastasis of a high gradeuro thelial carcinoma of urinary bladder and we review the literature.
Asunto(s)
Carcinoma de Células Transicionales/secundario , Neoplasias Gástricas/secundario , Neoplasias de la Vejiga Urinaria/patología , Carcinoma de Células Transicionales/patología , Resultado Fatal , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Gástricas/patologíaRESUMEN
Metastases to the stomach from an extra-digestive neoplasm are an unusual event, identified in less than 2
of cancer patients at autopsy (between 1.7
). The stomach may be involved by hematogenous spread from a distant primary tumor (most commonly lung, breast and melanoma). Tumors of neighboring organs, such as esophagus, pancreas and gallbladder, may reach the stomach by continuity or by lymphatic-hematogenous spread. Endoscopic routine studies with biopsies have improved the diagnosis of this pathology. Nevertheless, in some cases the histologic study is a false negative because the neoplasia can be placed in the deepest layers of the stomach. We report the case of a 56-year-old man who presented a gastric metastasis of a high gradeuro thelial carcinoma of urinary bladder and we review the literature.
Asunto(s)
Carcinoma de Células Transicionales/secundario , Neoplasias Gástricas/secundario , Neoplasias de la Vejiga Urinaria/patología , Carcinoma de Células Transicionales/patología , Resultado Fatal , Humanos , Masculino , Neoplasias Gástricas/patología , Persona de Mediana EdadRESUMEN
Acrometastasis is a rare occurrence, especially when affecting the hands. It represents around 0.007-0.2% of all metastatic lesions. The most common site of origin is the lung, accounting for 40-50% of all cases reported in the literature. Kidneys and breasts are other sites also associated with neoplastic lesions that disseminate to the hands. More rarely, the site of origin may be the gastrointestinal tract or other systemic tumors or sarcomas. Early diagnosis is difficult, since the condition may be asymptomatic or may mimic tenosynovitis, arthritis, paronychia, pyogenic granuloma or a local infection. In the present paper, the authors report on a patient with the diagnosis of acrometastasis on both hands originating from a basaloid carcinoma of the anal canal. Response to radiotherapy was poor.
Asunto(s)
Carcinoma de Células Transicionales/diagnóstico , Neoplasias del Colon/patología , Granuloma Piogénico/diagnóstico , Neoplasias Cutáneas/diagnóstico , Biomarcadores de Tumor/análisis , Carcinoma de Células Transicionales/secundario , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Persona de Mediana Edad , Neoplasias Cutáneas/secundarioRESUMEN
As acrometástases, principalmente para as mãos, são incomuns e representam cerca de 0,0070,2 por cento de todas as lesões metastáticas. O pulmão é o sítio de origem mais comum, colaborando com 4050 por cento dos casos relatados na literatura. Os rins e mamas são outras localizações também relacionadas a neoplasias que metastatizam para as mãos, além de, mais raramente, trato gastrointestinal, outros tumores sistêmicos e sarcomas. Seu diagnóstico precoce é difícil, pois pode ser assintomático, se assemelhar a tenossinovite, artrite, paroníquia, granuloma piogênico ou infecção local. No presente relato, os autores apresentam paciente com diagnóstico de acrometástase, em ambos os quartos quirodáctilos, oriunda de carcinoma basaloide de canal anal, com pobre resposta à radioterapia.
Acrometastasis is a rare occurrence, especially when affecting the hands. It represents around 0.007-0.2 percent of all metastatic lesions. The most common site of origin is the lung, accounting for 40-50 percent of all cases reported in the literature. Kidneys and breasts are other sites also associated with neoplastic lesions that disseminate to the hands. More rarely, the site of origin may be the gastrointestinal tract or other systemic tumors or sarcomas. Early diagnosis is difficult, since the condition may be asymptomatic or may mimic tenosynovitis, arthritis, paronychia, pyogenic granuloma or a local infection. In the present paper, the authors report on a patient with the diagnosis of acrometastasis on both hands originating from a basaloid carcinoma of the anal canal. Response to radiotherapy was poor.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Carcinoma de Células Transicionales/diagnóstico , Neoplasias del Colon/patología , Granuloma Piogénico/diagnóstico , Neoplasias Cutáneas/diagnóstico , Carcinoma de Células Transicionales/secundario , Diagnóstico Diferencial , Inmunohistoquímica , Neoplasias Cutáneas/secundario , Biomarcadores de Tumor/análisisRESUMEN
Transmission of urothelial carcinoma via solid organ transplant has never been reported in the literature to our knowledge. We report a case of transmission of this tumour to a kidney recipient. The donor was a 37-year-old woman, victim of a subarachnoid haemorrhage. The recipient was a 21-year-old girl, with a history of chronic kidney disease secondary to neurogenic bladder. This fatality has been rarely described in literature, but never with this histological type of cancer. Nowadays, with the expanded criteria for donation, older people are accepted as donor because of the shortage of organs. However, this may increase the likelihood of the number of cancer transmission.
Asunto(s)
Carcinoma de Células Transicionales/etiología , Neoplasias Renales/etiología , Trasplante de Riñón/efectos adversos , Carcinoma de Células Transicionales/secundario , Femenino , Humanos , Neoplasias Renales/patología , Neoplasias Pulmonares/secundario , Adulto JovenRESUMEN
OBJECTIVE: To describe the clinicopathological characteristics of patients with upper urinary tract transitional cell carcinomas who are treated surgically and to analyze the occurrence of bladder tumors as well as the development of metastases outside the urinary tract. MATERIALS AND METHODS: The study comprised a retrospective analysis of 25 patients treated between February 1994 and August 2006. The variables analyzed were: patient age, gender, and clinical presentation; diagnostic methods; pathologic characteristics at the primary site of the tumor (pelvis or ureter); tumor stage and grade; and presence of carcinoma in situ, microvascular invasion and squamous differentiation. The Kaplan-Meier method and the Log-Rank test were used for statistical analysis of bladder recurrence-free survival. RESULTS: Eighty-four percent of patients were male, and macroscopic hematuria was the most common clinical presentation. The majority of cases (56%) were infiltrative (T2-T3) and high-grade (76%) tumors. Synchronous or metachronous bladder tumors were found in 72% of cases. Five (20%) patients had a history of bladder tumor before the diagnosis of upper urinary tract transitional cell carcinomas. The mean follow-up period was 36 months (range: 1.5 to 156). During the follow-up period, eleven (44%) patients developed bladder tumors. After five years, the probability of being free of bladder tumor recurrence was 40%. No pathological variable was predictive for bladder tumor recurrence. Four patients presented disease recurrence outside the urinary tract. CONCLUSIONS: The presence of metachronous bladder tumors is more often observed after the diagnosis of upper urinary tract transitional cell carcinomas. All of these patients should undergo rigorous follow-up during the postoperative period. Only patients with infiltrative and high-grade tumors developed metastases outside the urinary tract.