Medizinische und chirurgische Urologie
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Concomitant Occurrence of Psoas Muscle and Splenic Metastasis from Squamous Cell Carcinoma of the Urinary Bladder: A Case Report

Bouchikhi AA, Amiroune D, Khallouk A, Tazi MF, Mellas S, El Ammari J, El Fassi MJ and Farih MH.

Introduction: Skeletal muscle is a rare localization of bladder cancer metastasis. Very few cases of urothelial carcinoma metastasis in psoas muscle were reported in the literature. We report concomitant psoas muscle tumor metastasis and splenic metastasis originated from urinary bladder squamous cell carcinoma. This association was never, described in earlier medical literature. Case report: The patient was 45 years old Moroccan male. He underwent trans-urethral bladder tumor resection (TURB). The diagnosis was done a month earlier in the emergency department while consulting for side pain and right leg swelling. The patient was feverish and showed an advanced general state deterioration. The CT-scan revealed a typical aspect of right psoas abscess associating a metastatic splenic localization. The ultrasound of the right leg showed an extended thrombophlebitis. The patient underwent a surgical drainage of psoas abscess and biopsies. The histopathological and immunohistochemistry studies demonstrated squamous carcinoma of the psoas muscle with very low differentiation. These tumors were originated from metastasis of this abscess. Despite the anticoagulant treatment, the patient died of pulmonary embolism after 3 weeks of surgical treatment. Conclusion: The reported psoas squamous carcinoma was originated in the bladder with splenic metastasis. It is the first report in the literature. Considering the possible metastatic origin of the psoas abscess, it is recommended to avoid a useless surgical drainage.