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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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Microscopic findings (hematoxylin and eosin stain): Well differentiated squamous cell carcinoma were found. Front formation(arrow head) were observed at the border between carcinoma cells and normal epithelial cells subcutaneously.
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Figure 3: Microscopic findings (hematoxylin and eosin stain): Well differentiated squamous cell carcinoma were found. Front formation(arrow head) were observed at the border between carcinoma cells and normal epithelial cells subcutaneously.

Mentions: After the local inflammation of the abdominal mass was resolved with intravenous antibiotics, a percutaneous biopsy was performed under local anesthesia. The histopathological examination of the biopsy specimens from the tumor suggested SCC (Figure 3). Thus, stage IV (cT4N1M1) epidermal SCC was diagnosed and subsequently treated with palliative external radiation therapy. A dose of 56 Gy was administered over 5 weeks to the pelvic area including the primary tumor and inguinal metastatic lymph nodes. The primary tumor and metastatic lymph nodes responded partially to this therapy. The period after radiotherapy was uneventful. The patient has remained asymptomatic during the subsequent 6 months.


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)

Microscopic findings (hematoxylin and eosin stain): Well differentiated squamous cell carcinoma were found. Front formation(arrow head) were observed at the border between carcinoma cells and normal epithelial cells subcutaneously.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Microscopic findings (hematoxylin and eosin stain): Well differentiated squamous cell carcinoma were found. Front formation(arrow head) were observed at the border between carcinoma cells and normal epithelial cells subcutaneously.
Mentions: After the local inflammation of the abdominal mass was resolved with intravenous antibiotics, a percutaneous biopsy was performed under local anesthesia. The histopathological examination of the biopsy specimens from the tumor suggested SCC (Figure 3). Thus, stage IV (cT4N1M1) epidermal SCC was diagnosed and subsequently treated with palliative external radiation therapy. A dose of 56 Gy was administered over 5 weeks to the pelvic area including the primary tumor and inguinal metastatic lymph nodes. The primary tumor and metastatic lymph nodes responded partially to this therapy. The period after radiotherapy was uneventful. The patient has remained asymptomatic during the subsequent 6 months.

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