PMC2818621_01
A: The pelvocalyceal tumor of the kidney reveals high-grade urothelial carcinoma (H&E, x100). B: PTNB from lung shows metastatic urothelial carcinoma (H&E, x200).
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F1
The resection margin was free from carcinoma, although there was metastatic carcinoma in one out of two lymph nodes (pT3N3 M0) (Figure 1A). A lung metastasis was confirmed to be urothelial cancer after a percutaneous transthoracic needle biopsy (Figure 1B) performed on a left lower lobe posterior segment metastatic lesion.
A, B: Chest CT demonstrating hematogenous metastastatic nodule in RML (arrow, A) disappeared after 4th FOLFOX4 cycles (B). C, D: Chest CT demonstrating hematogenous metastastatic nodule in LLL (arrow, C) that formed fibrotic cavity after 4th FOLFOX4 cycles (D).
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F2
Moreover, multiple lung metastases were seen on chest CT (Figure 2A, 2C). After four rounds of chemotherapy, the lung metastases all disappeared, except one fibrotic cavitary lung lesion (Figure 2B, 2D).
A: PET CT demonstrating no metastatic lesion after 8th FOLFOX4 cycles. B: PET CT demonstrating no FDG upake in the lung include left lower lobe.
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F3
Abdominal and chest CT performed after eight rounds of chemotherapy still showed no metastatic lesions, and positron emission tomography-computed tomography (PET-CT) showed no metastatic lesion (Figure 3A), with no 18F- fluoro-2-deoxyglucose (FDG) uptake in the fibrotic cavitary lesion in the lung (Figure 3B).