Malignant pericardial effusion as initial solitary site of metastasis from transitional cell carcinoma of the bladder

doi:10.1016/0090-4295(95)80025-5

Urology

Volume 45, Issue 2, February 1995, Pages 320-322

https://doi.org/10.1016/0090-4295(95)80025-5 Get rights and content

Abstract

A patient is presented whose first and sole evidence of metastatic transitional cell carcinoma of the bladder was pericardial metastasis with life-threatening cardiac tamponade. Definitive diagnosis and management was achieved with fluid cytology and video-assisted thoracic surgical pericardial biopsy and pericardial window.

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Cited by (22)

Urothelial bladder cancer with cardiac metastasis: Literature review and case report
2023, International Journal of Surgery Case Reports
Urothelial bladder cancer can infrequently result in cardiac metastasis, and be usually diagnosed in severe clinical conditions. We report a urothelial bladder cancer with cardiac metastasis and perform a literature review of published cases of transitional cell carcinoma (TCC) of the bladder with cardiac metastasis from 1934 to 2023 published in Pubmed.
42-year-old woman with urinnary bladder TCC, underwent radical cystectomy, developing cardiac metastasis after 25 months, cardiac surgery for partial removal of the lesion and using pembrolizumab with the highest reported survival to date.
After analysis of 20 case reports in the world among our case, men are more affected, tobacco exposure was the most prevalent risk factor, baseline T3 staging was the most common, and right ventricular and myocardium metastases are more prevalent. The most common symptoms were respiratory failure, changes in cardiac auscultation, and loss of weight. Six patients had cardiac tamponade, and the mean of drained fluid was 1040 ml. Immunohistochemical markers, such as CK7 and Calretinin, were decisive in elucidating the diagnosis. The average time between diagnosis of TCC and cardiac metastasis was 48.69 months, and the survival time after diagnosis of cardiac metastasis was 60.69 days.
Bladder TCC with cardiac metastasis is rare and with a low survival rate after the diagnosis. Patients with more advanced stages of TCC deserve diagnostic suspicion of cardiac metastasis if they progress with previously unreported respiratory and cardiac symptoms.
Rare presentation of urothelial bladder carcinoma as cardiac tamponade
2017, Urology Case Reports
Citation Excerpt :
There have been 5 documented cases of transitional cell carcinoma causing cardiac tamponade. There have been 3 documented cases of urothelial carcinoma presenting as cardiac tamponade with positive cytology.1–3 We will discuss a case in which pericardial effusion with tamponade was the initial presentation of the patient's transitional cell carcinoma of the bladder.
Unusual evolution of a plasmacytoid urothelial carcinoma of the bladder
2014, Revista Espanola de Patologia
Se comunica el caso de un hombre de 63 años que acudió a la consulta debido a un episodio de hematuria, por lo que se realizó una resección vesical transuretral, con diagnóstico de carcinoma infiltrante. Se llevó a cabo una cistectomía radical. En la pieza se identificó un tumor ulcerovegetante en la base de la vejiga. La microscopia mostró una infiltración de células malignas de aspecto plasmocitoide, positivas para CK7 y negativas para CK20 y CD138. El diagnóstico fue de carcinoma urotelial plasmocitoide. Tres meses después el paciente reingresó por taponamiento cardíaco. El examen citológico del líquido pericárdico demostró células similares a las de su carcinoma primario. El paciente murió 6 meses después del diagnóstico. El carcinoma urotelial representa el 90% de los carcinomas vesicales. Teniendo en cuenta sus variantes histopatológicas la forma plasmocitoide es inusual. Sus signos y síntomas no se presentan hasta que la enfermedad ha progresado a una etapa avanzada, lo que conlleva un mal pronóstico y curso agresivo. La histología es característica: las células presentan aspecto plasmocitoide y son por lo general CK7 y CK20 positivas. Hasta un 94% pueden ser positivas para CD138. Los principales diagnósticos diferenciales son plasmocitoma y linfoma con diferenciación plasmocitoide. La afectación cardiovascular es infrecuente. El carcinoma urotelial plasmocitoide es una entidad histopatológica que es difícil de diagnosticar debido su baja frecuencia, requiere el diagnóstico diferencial con otras enfermedades y su comportamiento es agresivo y atípico.
A 63 year old man presented with hematuria and underwent a transurethral resection of the bladder. A diagnosis of muscle invasive carcinoma was made and a radical cystectomy was performed. An ulcerating vegetative tumour was present in the base of the bladder. Microscopy revealed infiltration by atypical cells with plasmacytoid appearance and which were positive for CK7 and negative for CK20 and CD138. The final diagnosis was plasmacytoid urothelial carcinoma. Three months later the patient was readmitted with a cardiac tamponade. Cytology of the pericardial fluid revealed cells similar to those of the primary carcinoma. He died six months after initial diagnosis.
Urothelial carcinoma represents 90% of all bladder carcinomas and the plasmacytoid form is an unusual variant which only becomes clinically manifest when it reaches an advanced stage and behaves aggressively with a poor prognosis. It has a characteristic histology with cells with plasmacytoid appearance which are usually positive for CK7 and CK20. Up to 94% can be positive for CD138. The main differential diagnoses are plasmacytoma and plasmacytoid lymphoma. Cardiovascular involvement is unusual. Plasmacytoid urothelial carcinoma poses diagnostic problems due to its rarity. Careful differential diagnosis should be made. Its behavior is aggressive and atypical.
Nasopharyngeal carcinoma with pericardial metastasis
2011, Kaohsiung Journal of Medical Sciences
Citation Excerpt :
Primary tumors of the heart and pericardium are extremely rare, whereas secondary or metastatic pericardial tumors are not uncommon, with most of the secondary tumors arising from primary cancers of the lung, breast, stomach and esophagus, and hematological malignancies [6]. Pericardial metastases have been reported from rare primary cancer sites/organs, such as oral mucosa, uterine cervix, urinary bladder, and sigmoid colon [7–10]. NPC is extremely rare as the primary cancer with pericardial metastasis.
Nasopharyngeal carcinoma (NPC) is prevalent in Taiwan and is characterized by a high frequency of nodal metastasis. The most common organs with distal metastases are the bones, lungs, and liver, with extremely rare cases to the pericardium. Herein, we report a rare case with NPC who presented with dyspnea and orthopnea. Serial studies, including pericardial biopsy, revealed NPC with pericardial metastasis and pericardial effusion. The tumor cells of both the original and metastatic tumors were positive for Epstein–Barr virus by in situ hybridization. This is the first histologically confirmed case of NPC with pericardial metastasis.
Rare locations of metastases from urothelial carcinoma
2008, Progres en Urologie
Les localisations secondaires les plus fréquentes des carcinomes urothéliaux sont le foie, les poumons et l’os. De nombreux autres sites ont été décrits dans la littérature. Une synthèse la plus exhaustive possible a été entreprise en utilisant les bases de Pubmed et Cochrane pour répertorier ces localisations métastatiques atypiques que nous rapportons ici.
The liver, the lungs lung and bone are the most frequent sites for urothelial carcinoma metastasis. Nevertheless many other areas have also been described. Using Pubmed and Cochrane the most exhaustive research possible has been carried out to list these secondary urothelial carcinoma lesions.
Transitional cell carcinoma and right ventricular obstruction
1997, Journal of Urology

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Case reportMalignant pericardial effusion as initial solitary site of metastasis from transitional cell carcinoma of the bladder

Abstract

J Urol

Urology

Urology

J Urol

Urology

Am Heart J

Am J Med Sci

J Urol

Ann Thorac Surg

Case report
Malignant pericardial effusion as initial solitary site of metastasis from transitional cell carcinoma of the bladder