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J Coll Physicians Surg Pak · Aug 2022
Case ReportsAssociation between Serum Carcino-embryonic Antigen Levels and Micropapillary Bladder Cancer Metastasis in an Elderly Male.
- Caner Ediz, Neslihan Kaya Terzi, Serkan Akan, and Omer Yilmaz.
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey.
- J Coll Physicians Surg Pak. 2022 Aug 1; 32 (8): S186-S188.
AbstractWe, herein, present a case of a micropapillary variant of bladder cancer metastasizing to lymph nodes in an 87-year male with elevated serum carcinoembryonic antigen (CEA) levels (2637.8 ng/mL). The patient was evaluated for dyspeptic symptoms and elevated CEA levels. Colonoscopy and upper gastrointestinal endoscopy were normal. Contrast-enhanced computed tomography revealed a bladder tumour. Transurethral resection of bladder tumour (TUR-BT) was performed, and histologically, the tumour was reported as urothelial carcinoma (UC), high grade, and pT1. Intravesical Bacillus Calmette-Guérin (BCG) was started three weeks after TUR-BT and continued for two years. F-18 FDG PET/CT scans were performed every six months during the follow-up due to persistently elevated CEA levels. During follow-up, there was no recurrence of UC in the bladder. Two years later, he was admitted again with lymph node swelling in the left inguinal area. A tru-cut biopsy was performed, which showed UC with a micropapillary component. Gemcitabine monotherapy was given, which resulted in partial response, and a significant decline in serum CEA levels (490.17 ng/mL). Key Words: Carcinoembryonic antigen, Urothelial carcinoma, Bladder cancer, Micropapillary variant, Gemcitabine monotherapy.
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