[Cutaneous metastases from transitional cell carcinoma of the bladder producing beta-HCG]. / Metástasis cutáneas de un carcinoma transicional vesical productor de beta-HCG.

In spite of the high incidence of transitional cell carcinoma, cutaneous metastases are infrequent, especially when they are the first sign of metastatic spread, with a low survival rate. Thirty five per cent of transitional cell carcinoma of the bladder have ectopic beta- human chorionic gonadotropin (beta-HCG) production. It has been related with high grade tumors, advanced stage, metastatic disease, radioresistent tumors and low survival rate because of its effect as a growth modulator with a probably antagonist action in the apoptotic cascade. We present a thirty six years old woman affected by a transitional cell carcinoma of the bladder producing beta-HCG that showed two cutaneous metastases as first sign of metastatic disease. The exceptional coincidence of these two circumstances announced a very aggressive tumor behaviour and bad prognostic, with a quickly multiple metastatic dissemination including a pericardic metastases.

Metástasis cutáneas de un carcinoma transicional vesical productor de β-HCG / Cutaneous metastases from transitional cell carcinoma of the bladder producing β-HCG

A pesar de la alta incidencia de carcinoma transicional vesical, la aparición de metástasis cutáneas es infrecuente, más aún como primera manifestación de diseminación metastásica, asociándose a una pobre supervivencia. La producción ectópica de beta-gonadotropina coriónica humana (β-HCG) ocurre en un 35% de los carcinomas transicionales vesicales y se ha correlacionado con tumores de alto grado, estadios avanzados, enfermedad metastásica, falta de respuesta a la radioterapia y pobre supervivencia, en virtud de su efecto regulador del crecimiento tumoral por un probable efecto antagonista sobre receptores de la cascada apoptótica. Presentamos el caso de una paciente de 36 años con carcinoma transicional de vejiga productor de β-HCG que presentó dos metástasis cutáneas como primer signo de enfermedad a distancia. Ambas circunstancias asociadas de forma excepcional identificaron un comportamiento muy agresivo del tumor y su mal pronóstico, desarrollando a corto plazo un estallido metastático a múltiples niveles incluyendo una metástasis pericárdica (AU)

In spite of the high incidence of transitional cell carcinoma, cutaneous metastases are infrequent, especially when they are the first sign of metastatic spread, with a low survival rate. Thirty five per cent of transitional cell carcinoma of the bladder have ectopic beta- human chorionic gonadotropin (β-HCG) production. It has been related with high grade tumors, advanced stage, metastatic disease, radio resistent tumors and low survival rate because of its effect as a growth modulator with a probably antagonist action in the apoptotic cascade.We present a thirty six years old woman affected by a transitional cell carcinoma of the bladder producing β-HCG that showed two cutaneous metastases as first sign of metastatic disease. The exceptional coincidence of these two circumstances announced a very aggressive tumor behaviour and bad prognostic, with a quickly multiple metastatic dissemination including a pericardic metastases (AU)