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Case Report
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| Peritoneal carcinomatosis in urinary bladder cancer: A case report | ||||||
| Manraj Khosla1, Ali Imran2, Panagiotis Fidias3 | ||||||
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1Department of Internal Medicine, St Joseph's Hospital and Medical Center, Creighton University Medical School, Phoenix, AZ, USA.
2Ross University School of Medicine, Tempe, AZ, USA. 3Department of Oncology, Massachusetts Gender Hospital, Harvard, Boston, MA, USA. | ||||||
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| How to cite this article |
| Khosla M, Imran A, Fidias P. Peritoneal carcinomatosis in urinary bladder cancer: A case report. Int J Case Rep Images 2016;7(11):749–753. |
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Abstract
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Transitional cell carcinoma (TCC) is associated with malignant tumors that arise from stem cells near the basement membrane of the epithelial bladder surface. Exposure of carcinogens to the urothelium leads to genetic alterations in cells, increasing the malignant potential. Of the different environmental exposures, cigarette smoke is considered the greatest risk factor in the development of TCC in the United States. Pathological tumor growth patterns are classified as papillary (most common), sessile/mixed, or nodular, with TCC often arising via the flat or papillary pathways. Most commonly, TCC involves the papillary pathway, with formation of a tumor projecting into the bladder lumen and possible invasion of the lamina propria and bladder muscle. Constitutional symptoms such as weight loss, fatigue, along with lower abdominal pain or bone pain are often indicative of metastatic disease and poor prognosis. Metastasis of TCC most commonly occurs to the lungs, liver, or bone. Metastasis to the peritoneum with abdominal ascites, however, is very rare. In our case, TCC with peritoneal carcinomatosis and ascites in a 48-year-old male smoker can be appreciated. Abdominal pain with nausea, weight loss, and hematuria lead to computed tomography (CT) scan, which depicted ascites, omental thickening, and soft tissue mass in the urinary bladder. Biopsy and pathologic cytology revealed high-grade TCC with papillary morphology. Transitional cell carcinoma with peritoneal carcinomatosis is a rare cause of bladder carcinoma. Poor prognosis is due to advanced disease stage, poor performance status, and metastasis. Effective treatment often cannot be initiated, because of the grim presentation.
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Keywords:
Papillary tumor, Peritoneal carcinomatosis, Transitional cell carcinoma
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Author Contributions
Manraj Khosla – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Ali Imran – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Panagiotis Fidias – Analysis and interpretation of data, Drafting the article, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Manraj Khosla et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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