Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 15, Number 7, July 2024, pages 130-135

Metastatic Bladder Urothelial Carcinoma Masquerading as Myositis

Figures

Figure 1.
Figure 1. Computed tomography (CT) scans of the right thigh with contrast showing abnormal enhancement within the quadriceps musculature (arrow). Listed differentials included acute infectious/inflammatory myositis, rhabdomyolysis, and compartment syndrome.
Figure 2.
Figure 2. Immunohistochemical stains. (a) Hematoxylin and eosin (H&E) depicts infiltrative neoplastic cells into skeletal muscle (black arrow: skeletal myocytes are large and eosinophilic, blue arrow: infiltrating neoplastic cells). (b) Pan-keratin shows the neoplastic cells are carcinoma cells which also stain positive for cytokeratin 7 (c) and cytokeratin 20 (d). (e) GATA-binding protein 3 (GATA3) shows nuclear staining of carcinoma cells. (f) Desmin highlights the degeneration of muscle bundles secondary to the infiltrative carcinoma. (g-i) Carcinoma cells stain negative for transcription termination factor 1 (TTF-1), paired box 8 (PAX-8) and NK3 homeobox 1 (NKX 3.1).

Table

Table 1. Summary of Published Cases of Metastatic Bladder Urothelial Carcinoma to Skeletal Muscles
 
First authorYearAgeSexKnown bladder primary (yes/no)Site of skeletal muscle metastasisSurvival after metastasis detection
If the patient is alive at the time of publication, the survival time depicted by “>” sign and the time of latest follow-up.
Masters [16]199662MYesRight psoas muscle13 months
61MYesLeft psoas muscle1 months
Ekici [17]199941MYesRight deltoid2 months
Zargooshi [18]200143MNoLeft psoas muscle3 months
Nabi [19]200270MNoLeft psoas muscleNot stated
Nagao [20]200463MYesRight gluteus maximus and right obturator externusNot stated
Efesoy [21]200967MYesL vastus medialis7 months
Ying-Yue [22]201083MNoMultifocal, > 5 muscle groupsNot stated
Kashyap [23]201064MYesMultifocal, > 5 muscle groupsNot stated
Doo [24]201245MYesLeft sartorius muscleNot stated
Journeay [25]201365MYesRight deltoid muscleNot stated
Koca [26]201462MYesRight adductor longus and right iliopsoas3 months
Katafigiotis [27]201451MYesLeft sartorius muscle> 7 months
Dell’Atti [28]201565MYesObturator muscle> 6 months
Guidi [29]201676MYesFlexor digitorum superficialis and flexor digitorum profundus5 months
Spinelli [30]201866MYesLeft gluteal muscle1 months
Mainwaring [31]201971MYesVastus lateralis> 2 years
Dang [32]202272MYesLeft posterior thigh compartmentNot stated