血吸蟲病相關之膀胱尿路上皮癌: 罕見病例報告及文獻回顧

康庭碩、潘岳

彰化基督教醫院 外科部 泌尿科

Schistosomiasis-associated urothelial carcinoma of urinary bladder: a rare case report with literature review

Ting-Shuo Kang, Pan Yueh

Divisions of Urology, Department of Surgery, Changhua Christian Hospital

Introduction:

Schistosomiasis is a significant parasitic disease affecting millions worldwide, particularly in tropical and subtropical regions. Chronic infection with Schistosoma haematobium has been strongly linked to bladder cancer, primarily squamous cell carcinoma (SCC), though urothelial carcinoma (UC) has also been reported. The relationship between schistosomiasis and bladder cancer is complex and may affect disease progression, treatment outcomes, and overall prognosis. This case report focuses on a patient with UC of the urinary bladder, which is distinct from the more commonly reported SCC associated with Schistosoma haematobium infection.

Case presentation:

A 66-year-old male who works in flower cultivation has been drinking groundwater and using it for bathing for decades. He experienced painless hematuria for one month and a diagnostic cystoscopy revealed tumors involving the entire urinary bladder, along with the presence of parasite eggs. The pathology report confirmed a diagnosis of high-grade papillary UC and Schistosoma eggs. Subsequent abdominal and pelvic computed tomography (CT) imaging staged the tumor as cT3N0M0 (stage IIIA). The patient underwent transurethral resection of bladder tumor (TURBT), followed by concurrent chemoradiotherapy (CCRT) and praziquantel treatment for schistosomiasis. Despite the treatment, the disease recurred with urinary tract infections. Later, chest CT showed multifocal masses and nodules in the lungs, suspicious for metastases, as well as mild pleural effusion and enlarged mediastinal lymph nodes. Finally, the patient expired due to septic shock, accompanied with respiratory failure.