Bladder Adenocarcinoma in a Constellation of Multiple Site Malignancies: An Unusual Case and Systematic Review
Daniel Porav-Hodade,
Raul Gherasim,
Andrada Loghin,
Bianca Lazar,
Ovidiu Simion Cotoi,
Mihail-Alexandru Badea,
Mártha Orsolya Katalin Ilona,
Ciprian Todea-Moga,
Mihai Dorin Vartolomei,
Georgescu Rares,
Nicolae Crisan,
Ovidiu Bogdan Feciche
Affiliations
Daniel Porav-Hodade
Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
Raul Gherasim
Department of Urology, Clinical County Hospital Mures, 540136 Târgu Mures, Romania
Andrada Loghin
Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
Bianca Lazar
Department of Pathophysiology, Clinical County Hospital Mures, 540136 Târgu Mures, Romania
Ovidiu Simion Cotoi
Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
Mihail-Alexandru Badea
Department of Dermatology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
Mártha Orsolya Katalin Ilona
Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
Ciprian Todea-Moga
Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
Mihai Dorin Vartolomei
Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
Georgescu Rares
Department of General Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
Nicolae Crisan
Department of Urology, Iului Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
Ovidiu Bogdan Feciche
Department of Urology, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
Background and Objectives: Multiple primary malignant tumors represent a small percentage of the total number of oncological cases and can involve either metachronous or synchronous development and represent challenges in diagnosis, staging, and treatment planning. Our purpose is to present a rare case of bladder adenocarcinoma in a female patient with multiple primary malignant tumors and to provide systematic review of the available literature. Materials and Methods: A 67-year-old female patient was admitted with altered general condition and anuria. The past medical history of the patient included malignant melanoma (2014), cervical cancer (2017), colon cancer (2021), obstructive anuria (2023), and liver metastasectomy (2023). Transurethral resection of bladder tumor was performed for bladder tumors. Results: Contrast CT highlighted multiple pulmonary metastases, a poly nodular liver conglomerate, retroperitoneal lymph node, II/III grade left ureterohydronephrosis, and no digestive tract tumor masses. The pathological result of the bladder resection showed an infiltrative adenocarcinoma. Conclusions: The difference between primary bladder adenocarcinoma tumor and metastatic colorectal adenocarcinoma is the key for the future therapeutic strategy. Identification and assessment of risk factors such as viral infection, radiotherapy, chemotherapy, smoking, and genetics are pivotal in understanding and managing multiple primary malignant tumors. Personalized prevention strategies and screening programs may facilitate the early detection of these tumors, whether synchronous or metachronous. The use of multicancer early detection (MCED) blood tests for early diagnosis appears promising. However, additional research is needed to standardize these techniques for cancer detection.
