Isolated peritoneal carcinomatosis in prostate cancer: from a successful hormonal management to a review of the literature.

Metastases from prostate cancer involve mainly the bone compartment. However, visceral metastases are found in up to 49% of metastatic patients, occurring mainly in late stages of the disease, and are correlated with poor outcome. Peritoneal carcinomatosis is rarely described in literature, particularly when not associated with other distant metastatic lesions. We present the management of a patient with prostate cancer progressing on androgen deprivation therapy with description of omental involvement on 68Ga PSMA-PET. There was no ascite or other distant lesion, reflecting thus a specific tropism of the cancer in this patient who had no history of prostate surgery. Abiraterone acetate resulted in a long-lasting complete response. We also present a review focusing on this entity.

Laparoscopic partial cystectomy for venous malformation of the bladder.

Venous malformation (VM) of bladder is uncommon. We report the case of a VM involving bladder that was initially misdiagnosed as endometriosis based on symptomatology, histology and imaging. After failure of hormonal agent and increasing symptoms, a laparoscopic partial cystectomy was performed with a rapid improvement. Pathology diagnosis confirmed a VM. The 6-month cystoscopy showed the persistence of a vascularized lesion, reflecting an uncomplete resection. We decided to closely follow the patient and after 24 months, the lesion was stable and our patient remained asymptomatic. This case highlights the importance of considering VM in atypical urological symptoms and bladder lesion.

Immune checkpoint inhibitors as a real hope in advanced urothelial carcinoma.

Metastatic urothelial cancer is an aggressive disease associated with a poor prognosis. In the first-line setting, platinum-based chemotherapy is the standard of care but resistance rapidly occurs. After failure of platinum-based therapy and in cisplatin-ineligible patients, therapeutic options are limited. Malignant cells evolve mechanisms to evade immune recognition, including the expression of cell-surface molecules, named immune checkpoints, on tumor and tumor-specific lymphocytes. Immunotherapy, by targeting these checkpoints, represents a new tool to improve the patient outcome in advanced urothelial carcinoma (UC). Recently, the US FDA approved, in a short time, several immune checkpoint inhibitors in metastatic UC, both after failure of platinum-based therapy and in first-line setting in cisplatin-ineligible patients. This article aims to review the place of immunotherapy in advanced UC.