ABSTRACT
INTRODUCTION: The increased risk of developing a transitional cell carcinoma (TCC) among patients irradiated for other pathologies in a known fact, but many times forgotten due to its low incidence. Our aim is to review the association between radiotherapy (RT) and muscle-infiltrating TCC among our patients. MATERIAL AND METHODS: Clinical survey among our muscle-infiltrating TCC data base since 1975. Descriptive analysis of found cases. RESULTS: We found 5 patients who developed muscle-infiltrating TCC with a mean time of 19.2 years since radiotherapy (three of them more than 20 years and the other two less than 10 years). Three patients also developed other tumours or pathologies related to radiotherapy. Two of them had an upper tract muscle-infiltrating TCC and required nephroureterectomy. All of them had high risk TCC of the bladder and one developed distant metastasis. CONCLUSIONS: Patients under abdomino-pelvic RT and a prolongued follow-up, can be considered a risk group for developing muscle-infiltrating TCC. Thus, either micro or macrohaematuria or irritative symptoms should lead us to think in this possibility, demanding complete and exhaustive study to rule out TCC in all the urothelium.
Subject(s)
Carcinoma, Transitional Cell/etiology , Neoplasms, Radiation-Induced , Urinary Bladder Neoplasms/etiology , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Radiotherapy/adverse effects , Time FactorsABSTRACT
Introducción; El incremento del riesgo de desarrollar un tumor de células transicionales (TCT) en los pacientes tratados con radioterapia y quimioterapia por otras patologías es un hecho conocido, pero muchas veces no tenido en cuenta por su rareza. Nuestro objetivo es revisar el comportamiento clínico de esta asociación en nuestro centro. Material y métodos; Nuestra casuística de TCT infiltrante con antecedentes de irradiación abdómino pélvica desde 1975. Análisis descriptivo de los casos encontrados con dichos antecedentes. Resultados; Encontramos 5 pacientes que desarrollaron TCT infiltrante a una media de 19,2 años tras radioterapia (tres de ellos con un seguimiento superior a 20 años y los dos restantes inferior a 10 años). Tres pacientes desarrollaron otro tipo de tumores o lesiones radio inducidas. En dos de ellos coexisten un TCT infiltrante detracto urinario superior que requirió nefroureterectomía. Los 5 casos desarrollaron TCT de vejiga de alto grado y un paciente desarrolló metástasis por TCT. Conclusiones; Los pacientes con irradiación abdómino pélvica con un seguimiento prolongado constituyen un grupo de riesgo para el desarrollo de TCT infiltrante. Por tanto, la presencia de hematuria debe alertarnos y exige completar los algoritmos validados para el diagnóstico de TCT en todo el urotelio (AU)
Introduction: The increased risk of developing a transitional cell carcinoma (TCC) among patients irradiated for other pathologies in a known fact, but many times forgotten due to its low incidence. Our aim is to review the association between radiotherapy (RT) and muscle-infiltrating TCC among our patients. Material and methods: Clinical survey among our muscle-infiltrating TCC data base since 1975. Descriptive analysis of found cases. Results: We found 5 patients who developed muscle-infiltrating TCC with a mean time of 19.2 years since radiotherapy (three of them more than 20 years and the other two less than 10 years). Three patients also developed other tumours or pathologies related to radiotherapy. Two of them had an upper tract muscle- infiltrating TCC and required nephroureterectomy. All of them had high risk TCC of the bladder and one developed distant metastasis. Conclusions: Patients under abdomino-pelvic RT and a prolongued follow-up, can be considered a risk group for developing muscle-infiltrating TCC. Thus, either micro or macrohaematuria or irritative symptoms should lead us to think in this possibility, demanding complete and exhaustive study to rule out TCC in all the urothelium (AU)
