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Case Reports
A Rare Case Report of Metastatic Urothelial Carcinoma to Skull with Significant Reossification after Pembrolizumab.
- Yung-Hao Liu, Meng-Han Chou, En Meng, and Chien-Chang Kao.
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Gung Road, Nei-Hu, Taipei 114, Taiwan.
- Medicina (Kaunas). 2021 Sep 18; 57 (9).
AbstractBackground: Urothelial carcinoma ranks as the fourth most common cancer in men in the U.S; upon diagnosis, 10-15% have metastasized, mostly to lymph nodes, liver, lung, bone, and adrenal glands. Very few cases of skull invasion have been reported, and there is no established definite treatment. Case presentation: A 64-year-old Taiwanese male presented with metastatic urothelial carcinoma (mUC) of bladder with skull invasion. A sunken forehead without painful sensation could be palpated. After failure of chemotherapy, the patient received immunotherapy pembrolizumab, and complete remission of distant metastasis with reossification of osteolytic skull were noted. Conclusion: Immunotherapy has been reported to show significant remission in mUC, but mostly in solid organs or bone. While skull metastasis usually suggests late progression of the disease, immunotherapy has fewer systemic adverse effects than chemotherapy, and should be taken into consideration as a first-line therapy.
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