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Case Report
Massive renal pelvis urothelial carcinoma with invasion of the descending colon and cutaneous metastases: A case report and literature review
1 Department of Urology, Taitung Mackay Memorial Hospital, Taitung, Taiwan
2 Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
3 Department of Colorectal Surgery, Taitung Mackay Memorial Hospital, Taitung, Taiwan
4 Department of General Surgery, Taitung Mackay Memorial Hospital, Taitung, Taiwan
5 Department of Pathology, Taitung Mackay Memorial Hospital, Taitung, Taiwan
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Ti-Yuan Yang
No. 1, Ln. 303, Changsha St., Taitung City, Taitung County,
Taiwan
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Article ID: 100135Z12TY2024
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Yang TY, Hung YT, Huang SS, Chu CY. Massive renal pelvis urothelial carcinoma with invasion of the descending colon and cutaneous metastases: A case report and literature review. J Case Rep Images Surg 2024;10(1):34–38.ABSTRACT
Introduction: Skin metastases and gastrointestinal tract involvement in upper tract urothelial carcinoma (UTUC) are uncommon and associated with an adverse prognosis. This report details a case of extensive urothelial carcinoma originating from the renal pelvis, invading the descending colon, and presenting with cutaneous metastases.
Case Report: A 63-year-old male patient visited the emergency department on the account of sudden onset of severe left upper abdominal pain and nausea. The computed tomography (CT) revealed soft tissue density at the mesentery adjacent to the left kidney with the involvement of the distal transverse colon. The patient underwent left radical nephroureterectomy, left hemicolectomy, and bladder cuff excision. Six weeks postoperatively, left inguinal cutaneous metastases, approximately 4 cm, were excised. Due to renal dysfunction, the patient received gemcitabine and carboplatin chemotherapy, followed by pembrolizumab for the cutaneous metastatic disease. Follow-up imaging showed no evidence of recurrence or metastasis 15 months postoperatively.
Conclusion: In cases of advanced UTUC, a multidisciplinary approach combining surgical intervention, chemotherapy, and immunotherapy can alleviate symptoms and potentially improve survival rates. This integrative treatment strategy highlights the importance of a multidisciplinary approach in managing complex oncological cases.
Keywords: Cutaneous metastases, Nephroureterectomy, Upper tract urothelial carcinoma
SUPPORTING INFORMATION
Author Contributions
Ti-Yuan Yang - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Yu-Ting Hung - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Shou-Sen Huang - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Chia-Ying Chu - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Ti-Yuan Yang 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.
