Introduction
Bladder cancer is the 4th most common tumor, however, secondary bladder tumors are rare, involving less than 1% of all tumors in this organ. We present three cases of bladder involvement due to extraurothelial lineage tumors.
Patient information and clinical findings
Case 1: 34 years old male patient, who presented episodes of acute urine retention (AUR), macroscopic hematuria and pain in the right iliac fossa in October 2020. Magnetic resonance (MRI) revealed a mass in right seminal vesicle.
Case 2: 46 years old male patient, underwent subtotal gastrectomy for carcinoid tumor in december 2018, that in control PET-CT shows recurrence in form of a tumor mass in seminal vesicles. Asymptomatic, from urologic point of view.
Case 3: 54 years old male patient, diagnosed of intestinal origin GIST located in left iliac fossa, with left kidney involvement, therefore was performed nephroureterectomy in march 2020. Patient has presented macroscopic hematuria.
Diagnosis and Treatment:
Case 1: Biopsy was diagnostic of squamous carcinoma. TAP CT revealed involvement mesorectal fascia, iliac chains, bladder wall and left distal ureter. Multidisciplinary committee decides start treatment with neoadjuvant chemotherapy and radiotherapy, achieving a partial response to treatment. Therefore, radical cystoprostatectomy and rectal resection were performed in July 2021.
Case 2: An extension study through CT TAP and pelvic MRI was performed, which confirmed the mass in seminal vesicles, with bladder and anterior rectal wall infiltration. Biopsy was diagnostic of neuroendocrine tumor. Radical cystoprostatectomy and rectal resection were performed in december 2019. Nonetheless, he presents disease progression and he is in treatment with Irinotecan.
Case 3: Despite Imatinib treatment, control MRI revealed disease progression as well as bladder wall involvement, that was confirmed by cystoscopy. Currently, we're waiting to pathologic diagnosis, to assess the attitude towards bladder lesion. Conclusions:
Metastasis bladder are rare and usually, it occur as a manifestation of advanced disease and for dissemination from adjoining organs (prostate, female genital tract, colon). Most patients with secondary bladder involvement present symptoms, like hematuria and AUR. In the same way, it's common that there is involvement of other organs at the time of diagnosis.
Definitive diagnosis and management of secondary bladder tumors is often complicated. It's important rule out the primary origin of the bladder lesions and and confirm the diagnosis of metastasis by radiological and pathological study. In the presence of histology other than urothelial, we must rule out the metastatic origin of the lesion.

BLADDER INVOLVEMENT DUE TO EXTRA- UROTHELIAL LINEAGE TUMORS: REPORT OF THREE CASES

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