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      Curative resection of bladder cancer with pancreas head metastasis

      case-report

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          Abstract

          Bladder cancer is the 9th most frequent cancer worldwide. Its incidence is increasing. The pancreas is an infrequent site of metastasis in relation to any type of malignancy. In this study, we report our experience with a patient who has undergone a pancreaticoduodenectomy for metastatic bladder cancer. A 61-year-old male was admitted with jaundice and pancreas head mass. He underwent robot assisted-cystectomy and ileal conduit for bladder cancer 7 months ago. Initial diagnosis under the imaging study was a resectable pancreas head cancer. However, we did not rule-out a metastatic bladder cancer. He underwent a classic pancreaticoduodenectomy. Based on histologic findings and immunohistochemistry results, a pancreas tumor with 4.9-cm sized metastatic urothelial carcinoma was diagnosed. He experienced no complication. He was discharged 11 days after the surgery. Four cycles of gemcitabine and cisplatin were administered. He remained recurrence-free of tumors for 16 months. Although the benefit of pancreatectomy for patient survival has been reported for metastases from renal cell carcinoma, it is unknown for bladder cancer because of no report. We believe that curative resection for metastasis to pancreas of urothelial carcinoma might be helpful for its management.

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          Most cited references8

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          Bladder Cancer Incidence and Mortality: A Global Overview and Recent Trends.

          Bladder cancer has become a common cancer globally, with an estimated 430 000 new cases diagnosed in 2012.
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            Epidemiology and risk factors of urothelial bladder cancer.

            Urothelial bladder cancer (UBC) is a disease of significant morbidity and mortality. It is important to understand the risk factors of this disease. To describe the incidence, prevalence, and mortality of UBC and to review and interpret the current evidence on and impact of the related risk factors. A literature search in English was performed using PubMed. Relevant papers on the epidemiology of UBC were selected. UBC is the 7th most common cancer worldwide in men and the 17th most common cancer worldwide in women. Approximately 75% of newly diagnosed UBCs are noninvasive. Each year, approximately 110 500 men and 70 000 women are diagnosed with new cases and 38 200 patients in the European Union and 17 000 US patients die from UBC. Smoking is the most common risk factor and accounts for approximately half of all UBCs. Occupational exposure to aromatic amines and polycyclic aromatic hydrocarbons are other important risk factors. The impact of diet and environmental pollution is less evident. Increasing evidence suggests a significant influence of genetic predisposition on incidence. UBC is a frequently occurring malignancy with a significant impact on public health and will remain so because of the high prevalence of smoking. The importance of primary prevention must be stressed, and smoking cessation programs need to be encouraged and supported. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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              Metastatic pattern of bladder cancer: correlation with the characteristics of the primary tumor.

              The purpose of this study was to evaluate the metastatic pattern of muscle-invasive bladder cancer and to correlate the findings with the characteristics of the primary tumor. From a clinic population of 392 patients with muscle-invasive (pT2-4) bladder cancer seen at our institution from January 2004 through December 2009, we studied the cases of 150 consecutively registered patients with pathologically proven metastatic disease. The metastasis-free intervals and metastatic patterns of different T categories were compared by Kruskal-Wallis test and Freeman-Halton extension of Fisher's exact test. Patients were divided into two histologic categories, those with transitional cell carcinoma and those with atypical histologic features. The metastasis-free interval and metastatic pattern of these two groups were compared by Mann-Whitney test and Fisher's exact test. The study group consisted of 150 patients (116 men [77%], 34 women [23%]; median age, 64 years). The transitional cell carcinoma group consisted of 94 (63%) patients and the atypical histologic features group of 56 (37%) patients. The most common metastatic sites were lymph nodes (104 patients, 69%), bone (71 patients, 47%), lung (55 patients, 37%), liver (39 patients, 26%), and peritoneum (24 patients, 16%). Patients with tumors of a more advanced T category had shorter metastasis-free intervals (p = 0.001, df = 2). There was no significant difference in the metastatic patterns of tumors in the different T categories. Patients with atypical histologic features had a shorter median metastasis-free interval (3 months; range, 0-29 months) than patients with transitional cell carcinoma (12 months; range, 0-192 months) (p = 0.0001). Patients with atypical histologic features had a significantly higher incidence of peritoneal metastasis (p < 0.0002). Lymph nodes, bones, lung, liver, and peritoneum are the most common sites of metastasis from bladder cancer. Tumors in a more advanced T category and those with atypical histologic features metastasize earlier. Tumors with atypical histologic features also have a higher frequency of peritoneal metastasis.
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                Author and article information

                Journal
                Ann Hepatobiliary Pancreat Surg
                Ann Hepatobiliary Pancreat Surg
                Annals of Hepato-Biliary-Pancreatic Surgery
                The Korean Association of Hepato-Biliary-Pancreatic Surgery
                2508-5778
                2508-5859
                31 August 2021
                31 August 2021
                31 August 2021
                : 25
                : 3
                : 440-444
                Affiliations
                [1 ]Department of Surgery, Biomedical Research Institute and Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
                [2 ]Department of Radiology, Biomedical Research Institute and Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
                [3 ]Department of Urology, Biomedical Research Institute and Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
                [4 ]Department of Pathology, Biomedical Research Institute and Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
                Author notes
                Corresponding author: Hyung-Il Seo Department of Surgery, Biomedical Research Institute and Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea, Tel: +82-51-240-7238, Fax: +82-51-247-1365, E-mail: seohi71@ 123456hanmail.net , ORCID: https://orcid.org/0000-0002-4132-7662
                Author information
                https://orcid.org/0000-0002-4165-3054
                https://orcid.org/0000-0002-4132-7662
                https://orcid.org/0000-0002-1731-0430
                https://orcid.org/0000-0003-3268-1763
                https://orcid.org/0000-0002-0379-2790
                https://orcid.org/0000-0002-6465-9811
                Article
                ahbps-25-3-440
                10.14701/ahbps.2021.25.3.440
                8382865
                34402450
                0487b165-a8d8-481a-a657-a9d139fb1475
                Copyright © 2021 by The Korean Association of Hepato-Biliary-Pancreatic Surgery

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 January 2021
                : 09 February 2021
                : 14 February 2021
                Categories
                Case Report

                uurinary bladder neoplasm,neoplasm metastasis,pancreaticoduodenectomy,pancreatic neoplasm

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