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A case of squamous cell carcinoma arising from a suprapubic cystostomy tract.

Ito H, Arao M, Ishigaki H, Ohshima N, Horita A, Saito I, Hirai K - BMC Urol (2011)

Bottom Line: A 58-year-old man with a complete spinal cord injury was referred to our hospital with a chief complaint of an abdominal mass.Histopathological examination of percutaneous biopsy specimens was performed.The diagnosis was stage IV (cT4N1M1) epidermal SCC, which was treated with palliative external radiation therapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Urology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan. pug_daikichi@yahoo.co.jp

ABSTRACT

Background: Patients with spinal cord injury and a chronic indwelling urinary catheter are known to have an increased risk of bladder malignancy. However, squamous cell carcinoma (SCC) of the epidermis around a suprapubic cystostomy is relatively rare. Here, we report a case of lower abdominal SCC arising from the suprapubic cystostomy tract.

Case presentation: A 58-year-old man with a complete spinal cord injury was referred to our hospital with a chief complaint of an abdominal mass. Abdominal enhanced computed tomography (CT) showed a 7-cm mass surrounding the suprapubic cystostomy and bilateral inguinal and para-aortic lymph nodes metastasis. Histopathological examination of percutaneous biopsy specimens was performed. The diagnosis was stage IV (cT4N1M1) epidermal SCC, which was treated with palliative external radiation therapy.

Conclusion: The SCC in this case was thought to arise from mechanical stimulus of the suprapubic cystostomy. Physicians and patients should pay careful attention to any signs of neoplasms with long-term indwelling catheters, such as skin changes around the suprapubic cystostomy site. This case presentation is only the fourth report of SCC arising from the suprapubic cystostomy tract in the literature. In cases of unresectable tumors and contraindications to chemotherapy, palliative radiotherapy may lead to disease remission and symptom relief.

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Abdominal Mass surrounding a suprapubic cystostomy. (a) The mass(50 mm diameter) was noted around the suprapubic catheter. (b) Closer view of the abdominal mass surrounding a suprapubic cystostomy.
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Figure 1: Abdominal Mass surrounding a suprapubic cystostomy. (a) The mass(50 mm diameter) was noted around the suprapubic catheter. (b) Closer view of the abdominal mass surrounding a suprapubic cystostomy.

Mentions: The physical examination revealed an abdominal mass surrounding a suprapubic cystostomy (Figure 1a). The skin around the mass was erythematous, edematous, and a foul-smelling, purulent discharge was present (Figure 1b). Blood analysis revealed the following abnormal values: albumin 2.3 g/dl, hemoglobin 8.6 g/dl, elevated white blood cells to 11,200/μl, and C-reactive protein 11.89 mg/dl. Urinalysis revealed leukocytes (< 100/HPF) and hematuria (50-99/HPF). Urine cytologic evaluation was class α and atypical squamous cells were seen on microscopic examination. Enhanced chest and abdominal CT (Figure 2) showed a mass (72 mm × 63 mm) surrounding the suprapubic cystostomy and enlarged bilateral inguinal and para-aortic lymph nodes. Chest and anterior mediastinal lesions showed no specific findings. A cystoscopy could not be performed because the patient had a lower-extremity contracture deformity.


A case of squamous cell carcinoma arising from a suprapubic cystostomy tract.

Ito H, Arao M, Ishigaki H, Ohshima N, Horita A, Saito I, Hirai K - BMC Urol (2011)

Abdominal Mass surrounding a suprapubic cystostomy. (a) The mass(50 mm diameter) was noted around the suprapubic catheter. (b) Closer view of the abdominal mass surrounding a suprapubic cystostomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198751&req=5

Figure 1: Abdominal Mass surrounding a suprapubic cystostomy. (a) The mass(50 mm diameter) was noted around the suprapubic catheter. (b) Closer view of the abdominal mass surrounding a suprapubic cystostomy.
Mentions: The physical examination revealed an abdominal mass surrounding a suprapubic cystostomy (Figure 1a). The skin around the mass was erythematous, edematous, and a foul-smelling, purulent discharge was present (Figure 1b). Blood analysis revealed the following abnormal values: albumin 2.3 g/dl, hemoglobin 8.6 g/dl, elevated white blood cells to 11,200/μl, and C-reactive protein 11.89 mg/dl. Urinalysis revealed leukocytes (< 100/HPF) and hematuria (50-99/HPF). Urine cytologic evaluation was class α and atypical squamous cells were seen on microscopic examination. Enhanced chest and abdominal CT (Figure 2) showed a mass (72 mm × 63 mm) surrounding the suprapubic cystostomy and enlarged bilateral inguinal and para-aortic lymph nodes. Chest and anterior mediastinal lesions showed no specific findings. A cystoscopy could not be performed because the patient had a lower-extremity contracture deformity.

Bottom Line: A 58-year-old man with a complete spinal cord injury was referred to our hospital with a chief complaint of an abdominal mass.Histopathological examination of percutaneous biopsy specimens was performed.The diagnosis was stage IV (cT4N1M1) epidermal SCC, which was treated with palliative external radiation therapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Urology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan. pug_daikichi@yahoo.co.jp

ABSTRACT

Background: Patients with spinal cord injury and a chronic indwelling urinary catheter are known to have an increased risk of bladder malignancy. However, squamous cell carcinoma (SCC) of the epidermis around a suprapubic cystostomy is relatively rare. Here, we report a case of lower abdominal SCC arising from the suprapubic cystostomy tract.

Case presentation: A 58-year-old man with a complete spinal cord injury was referred to our hospital with a chief complaint of an abdominal mass. Abdominal enhanced computed tomography (CT) showed a 7-cm mass surrounding the suprapubic cystostomy and bilateral inguinal and para-aortic lymph nodes metastasis. Histopathological examination of percutaneous biopsy specimens was performed. The diagnosis was stage IV (cT4N1M1) epidermal SCC, which was treated with palliative external radiation therapy.

Conclusion: The SCC in this case was thought to arise from mechanical stimulus of the suprapubic cystostomy. Physicians and patients should pay careful attention to any signs of neoplasms with long-term indwelling catheters, such as skin changes around the suprapubic cystostomy site. This case presentation is only the fourth report of SCC arising from the suprapubic cystostomy tract in the literature. In cases of unresectable tumors and contraindications to chemotherapy, palliative radiotherapy may lead to disease remission and symptom relief.

Show MeSH
Related in: MedlinePlus