Clinically node-positive micropapillary bladder cancer in a young female desiring to spare functional bladder and fertility.

A 38-year-old female developing pelvic lymph node recurrence (cN2) of bladder cancer was referred to our hospital. Eighteen months earlier, she had received complete transurethral resection of bladder tumor and pathological diagnosis of muscle-invasive urothelial carcinoma with micropapillary variant had been made. She had declined radical cystectomy or chemoradiation because of a strong desire to spare the bladder and fertility. She received induction gemcitabine/cisplatin therapy. After three cycles, she achieved a clinically complete response. Then, she underwent transumbilical gasless retroperitoneoscopic super-extended pelvic lymph node dissection up to the inferior mesenteric artery trunk using the three-dimensional head-mounted display system. Pathologically, one of 42 resected lymph nodes was positive for metastasis. She is alive with no evidence of disease 5 years after lymph node dissection, retaining functional bladder and normal ovarian functions.

International cancer conference journal. 2020 Apr 11*** epublish ***

Hiroshi Fukushima, Yasukazu Nakanishi, Madoka Kataoka, Ken-Ichi Tobisu, Fumitaka Koga

Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677 Japan.

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