PMC9499816_01
(a) MRI T2-weighted image and (b) diffusion-weighted image showed a bladder tumor (white arrowheads) with hematoma (white arrows). (c) The CT image after NAC did not show rapid progression of the bladder tumor (white arrowheads). (d) The FDG-PET findings when the patient presented with low back pain after the RC.
CRIU2022-6082700.001.jpg
PMC9499816_01_CRIU2022-6082700.001.jpg
fig1
Magnetic resonance imaging (MRI) revealed a tumor and a hematoma in the bladder (Figures 1(a) and 1(b)). CT imaging obtained after NAC did not show rapid progression of the bladder tumor (Figure 1(c)). The 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) findings revealed significant FDG uptake in nearly all bones (Figure 1(d)).
(a) HE staining of the tumor when transurethral electrocoagulation was performed. (b-d) Immunohistochemical staining findings of the tumor for pancytokeratin (b), GATA3 (c), and CD138 (d) when transurethral electrocoagulation was performed.
CRIU2022-6082700.002.jpg
PMC9499816_01_CRIU2022-6082700.002.jpg
fig2
The resection specimen did not contain bladder muscle (Figure 2(a)). The tumor cells were immunoreactive for pancytokeratin (Figure 2(b)), GATA3 (Figure 2(c)), and CD138 (Figure 2(d)), thereby leading to the diagnosis of invasive PUC, grade 3 (G3), pT1, or higher.
(a) HE staining and (b) immunohistochemical staining for E-cadherin expression of the tumor when transurethral electrocoagulation was performed. (c) HE staining and (d) immunohistochemical staining for GATA3 from the second bone marrow biopsy.
CRIU2022-6082700.003.jpg
PMC9499816_01_CRIU2022-6082700.003.jpg
fig3
Immunohistochemical staining for E-cadherin expression in PUC cells was negative, which suggested an aggressive phenotype of this bladder tumor (Figures 3(a) and 3(b)). Histological findings of the biopsy showed metastasis of the PUC (Figures 3(c) and 3(d)).