A case of isolated rectal recurrence of muscle invasive bladder cancer
We present the case of a 53-year-old man with a twenty-five pack year smoking history and a six month history of gross hematuria, who presented with a pT3a, N0, M0, muscle invasive bladder cancer (MIBC). He declined neoadjuvant chemotherapy but did receive post-cystectomy adjuvant chemotherapy. Six months post adjuvant chemotherapy he presented with abdominal pain and a large bowel obstruction, and was found to have an isolated rectal recurrence of MIBC. This case illustrates two important issues. The first being that patients with a smoking history and symptoms of hematuria need to be carefully evaluated to rule out urothelial cancer. And second, for patients with muscle invasive disease, local pelvic recurrence is common and close surveillance for recurrence needs to be implemented.
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